Effects of Different Mixing Agents on the Stability of Sodium Tetradecyl Sulfate (STS) Foam: An Experimental Study

Cardiovasc Intervent Radiol. 2018 Dec;41(12):1952-1957. doi: 10.1007/s00270-018-2049-2. Epub 2018 Aug 7.

Abstract

Purpose: To evaluate the effect of air, CO2 and contrast medium-air on the dwell time (DT) stability of sodium tetradecyl sulfate (STS) foam.

Materials and methods: Three types of foam sclerosants (air-foam, CO2-foam, contrast-air-foam) were injected eight times into an inclined straight plastic tube (internal diameters 4 mm and 10 mm) filled with a blood substitute. Injections were captured by CCD camera, and images were transferred for digital analysis and calculation of DT.

Results: Contrast-air-foam and air-foam in a 4-mm tube showed 5.6-/3.3-fold greater DT compared to CO2-foam, respectively (P = 0.001). Contrast-air-foam in a 10-mm tube showed 2.1-fold greater DT compared to CO2-foam (P = 0.0167).

Conclusion: A mixture of air and iodinated contrast improves the stability of STS foam compared to mixtures using only air or CO2. Further, animal and clinical studies are needed to validate this in vitro result.

Keywords: Fibro-vein; Foam sclerotherapy; Lower extremity varix; Polidocanol; Sodium tetradecyl sulfate (STS); Sotradecol; Venous malformation.

MeSH terms

  • Air*
  • Carbon Dioxide / chemistry*
  • Contrast Media / chemistry*
  • Humans
  • In Vitro Techniques
  • Iohexol / chemistry*
  • Sclerosing Solutions / chemistry*
  • Sodium Tetradecyl Sulfate / chemistry*
  • Viscoelastic Substances

Substances

  • Contrast Media
  • Sclerosing Solutions
  • Viscoelastic Substances
  • Carbon Dioxide
  • Iohexol
  • Sodium Tetradecyl Sulfate