Early histopathological effects of fluid versus foam sclerotherapy on great saphenous vein endothelium

Patients and methods: Vein samples were collected from a total of 22 patients (17 males, 5 females; mean age: 52.4±6.9 years; range, 38 to 63 years) undergoing surgical stripping of the great saphenous vein. We used 0.5%, 1.0% and 2.0% concentrations of lauromacrogol 400 (Aethoxysklerol, Cem Farma, Ankara, Turkey). Nine samples were treated with fluid polidocanol, nine were treated with foam polidocanol, and four for used as controls without being treated at all. Each sample was, then, cut into three 2 cm long segments. Of a total of 66 segments (27 were treated with fluid, 27 with foam, and 12 controls), 63 were found to be eligible for the histopathological examination.

Results: No significant differences were found among six different experiment groups in terms of focal endothelial swelling (p=0.23), necrosis (p=0.66), and intimal thickening (p=0.19), whereas tunica media edema was significantly less common in 2.0% foam sclerotherapy group, compared to all other intervention groups (p=0.03). Total damage scores were not significantly different between the samples exposed to liquid and foam (p=0.33).

Conclusion: Higher concentrations of the sclerosing agent produce a slight, non-significant increase in total damage to the vein wall, indicating that sclerotherapy may be effective even with low doses.