Sclerosant foams

 

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Summary

Numerous ways of transferring detergent type liquid sclerosants into foam have been described. Out of all techniques, the three most commonly used around the world were selected. Sclerosant foams prepared with different agents and protocols were analyzed in detail, and their rheologic properties were assessed. Some of the results are presented in this review. Results: It is evident that the the material for foam production plays an important role for foam stability, and – connected to this – maybe also for efficacy and safety. Therefore, material that ensures acceptable foam quality should be used exclusively. Out of a huge number of possibilities, the material described in this study was found most suitable. This ensures minimal reduction of foam quality delivered into the vein. Foams considered instable are not clinically ineffective. They have a greater efficacy than the corresponding liquid agent. Foams considered stable seem to need lower injection volumes to have the same or better physical behaviour. Conclusion: Since higher volumes of sclerosant foams are correlated with more side effects, always the smallest effective volumes of foams of appropriate quality are justified.

Zusammenfassung

Zahllose Möglichkeiten sind beschrieben, um aus flüssigen Detergenz-Sklerosierungsmitteln Schäume herzustellen. Die drei am häufigsten verwendeten der zahlreichen Techniken wurden gewählt. Sklerosierungsschäume, die mit unterschiedlichen Sklerosierungsmitteln und nach unterschiedlichen Herstellungsbeschreibungen generiert worden waren, wurden detailliert untersucht und ihre physikalischen Eigenschaften festgestellt. Einige der Ergebnisse werden beschrieben. Ergebnisse: Es ist eindeutig, dass das zur Schaumherstellung verwendete Material die Schaumstabilität erheblich beeinflusst, und – damit zusammenhängend – wohl auch Wirksamkeit und Sicherheit. Daher sollte ausschließlich Material verwendet werden, mit dem sich eine gute Schaumqualität sicher erreichen lässt. Aus einer Reihe ganz unterschiedlicher Möglichkeiten zeigte sich das hier beschriebene als das am Besten geeignete. Es sorgt dafür, dass die Qualität des intravenös gegebenen Schaums nur minimal sinkt. Instabile Schäume sind klinisch nicht ineffektiv, denn sie haben immer eine höhere Wirksamkeit als das zugrunde liegende flüssige Sklerosierungsmittel. Stabile Schäume aber benötigen offenbar geringere Injektionsvolumina um das gleiche oder ein besseres physikalisches Ergebnis zu erzeugen. Schlussfolgerung: Auch weil höhere Schaumvolumina mit mehr unerwünschten Nebenwirkungen korrelieren, sollte stets das geringste noch effektive Volumen eines Schaums ausreichender Qualität verwendet werden.

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