Detrimental influences of intraluminally-administered sclerotic agents on surrounding tissues and peripheral nerves: An experimental study

Autor:	Akihiko Takushima, Hayato Kawakami, Nobuyuki Kaji, Masahide Fujiki, Kiyonori Harii, Masakazu Kurita, Mine Ozaki
Rok vydání:	2012
Předmět:	Pathology medicine.medical_specialty Vascular Malformations medicine.medical_treatment Polidocanol Femoral vein Oleic Acids Vascular permeability Polyethylene Glycols Capillary Permeability Femoral nerve plastic surgery Sclerotherapy Animals Medicine Rats Wistar Ethanolamine Oleate nerves Ethanol business.industry Sclerosing Solutions Femoral Vein Nerve injury Rats Injections Intravenous Microscopy Electron Scanning Original Article Surgery Endothelium Vascular medicine.symptom business Femoral Nerve Fluorescein-5-isothiocyanate Extravasation of Diagnostic and Therapeutic Materials medicine.drug
Zdroj:	Journal of Plastic Surgery and Hand Surgery
ISSN:	2000-6764 2000-656X
DOI:	10.3109/2000656x.2012.675881
Popis:	The minimally-invasive nature of sclerotherapy makes it one of the first treatment options for venous malformations, although treatment-related complications, such as peripheral nerve paralysis, have been reported in some clinical cases. However, no studies of the aetiology of the detrimental effects of intraluminally-administered sclerotic agents on the surrounding tissues, including the peripheral nerves, have yet been published. This study therefore investigated the influences of intraluminally-administered sclerotic agents on the tissues surrounding the injection site using a newly-developed rat femoral vein model. Using this model, the effects of absolute ethanol, 5% ethanolamine oleate, and 1% polidocanol were compared histologically with those of normal saline controls. Fluorescein isothiocyanate-conjugated agents were administered and the leakage of sclerotic agents through the venous wall was evaluated by fluorescence microscopy. Damage to the adjacent femoral nerve was quantitatively evaluated by counting the numbers of axons in cross-sections. All the sclerotic agents caused vascular wall injuries and leakage into the surrounding tissues. The number of axons in the femoral nerve was significantly reduced following administration of absolute ethanol or 5% ethanolamine oleate, compared with normal saline. The results of this study suggest that sclerotic agents commonly leak out the vascular lumen, and some agents can cause adjacent nerve injury. It is important to be aware of this type of complication of sclerotherapy for venous malformations when selecting appropriate therapeutic interventions.
Databáze:	OpenAIRE
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