Pleurodesis: A Comparision of Two Sclerosing Agents for Pleural Effusion

Introduction: Pleural effusion is one of the most frequentlyencountered pathology in our hospital. Thoracocentesis,thoracostomy, pleurodesis is the most commonly usedtreatment options for recurrent and persistent pleural effusion.Sterile talc powder is most commonly used as an sclerosingagent. In our study we have used sodium tetradecyl sulfateas a newer sclerosing agent and we have compared thecomplication rate, clinical response and success rate inboth sodium tetradecyl sulfate and talc sclerosing agent forpleurodesis. Study aimed to compare the safety and efficacyof the sodium tetradecyl sulfate and talc as a pleurodesis agentin pleural effusion cases.Material and methods: Pleural effusion cases (both malignantand non-malignant cases) were randomly allocated into groupA or group B. Group A patients were treated with 60mg of3% sodium tetradecyl sulfate, Group B patients were treatedwith 2 grams of sterile talc powder. Clinical data regardinggeneral complications, the rate of success, reduction in ICDdrainage and lung expansion were noted for every patient whounderwent pleurodesis.Results: 25 patients were allocated in each group. Patientscharacteristics were balanced between the two groups withthe majority of pleural effusion malignant in etiology. There isa statistically significant difference between the use of sodiumtetradecyl sulfate and talc in clinical response, ICD drainageand lung re-expansion. Sodium tetradecyl sulfate patient hasbetter lung reexpansion and clinical response in comparison totalc powder. The general complication was observed to be lowwith sodium tetradecyl sulfate than talc pleurodesis.Conclusion: Sodium tetradecyl sulfate pleurodesis appearsto have better pleurodesis effect than talc pleurodesis in ourstudy

Orbital infarction syndrome after multiple percutaneous sclerotherapy sessions for facial low‑flow vascular malformation: A case report and literature review.

Vision loss following sclerotherapy for facial vascular malformations (VMs) is a rare but detrimental complication. Here, we report a case of an 11‑year‑old boy with acute onset blepharoptosis, ophthalmoplegia, and blindness in his right eye after the 14th sclerotherapy session (percutaneous intralesional injection of sodium tetradecyl sulfate) for a right facial low‑flow VM without orbital involvement. Computed tomography angiography revealed no contrast enhancement in the right ophthalmic artery, superior ophthalmic vein, or extraocular muscles. He presented with the hallmarks of orbital infarction syndrome: Clear signs of anterior and posterior segment ischemia and disrupted arterial flow to the extraocular muscles. His blepharoptosis and eye movement improved 4 months later; however, he remained blind, and phthisis bulbi developed eventually. Thus, sclerotherapy for facial VM—even without orbital involvement––may result in severe ocular and orbital complications.

Efficacy and Safety of Balloon-Occluded Retrograde Transvenous Obliteration with Sodium Tetradecyl Sulfate Liquid Sclerotherapy

OBJECTIVE: To evaluate the efficacy and safety of balloon-occluded retrograde transvenous obliteration (BRTO) with sodium tetradecyl sulfate (STS) liquid sclerotherapy of gastric varices. MATERIALS AND METHODS: Between February 2012 and August 2014, STS liquid sclerotherapy was performed in 17 consecutive patients (male:female = 8:9; mean age 58.6 years, range 44-86 years) with gastric varices. Retrograde venography was performed after occlusion of the gastrorenal shunt using a balloon catheter and embolization of collateral draining veins using coils or gelfoam pledgets, to evaluate the anatomy of the gastric varices. We prepared 2% liquid STS by mixing 3% STS and contrast media in a ratio of 2:1. A 2% STS solution was injected into the gastric varices until minimal filling of the afferent portal vein branch was observed (mean 19.9 mL, range 6-33 mL). Patients were followed up using computed tomography (CT) or endoscopy. RESULTS: Technical success was achieved in 16 of 17 patients (94.1%). The procedure failed in one patient because the shunt could not be occluded due to the large diameter of gastrorenal shunt. Complete obliteration of gastric varices was observed in 15 of 16 patients (93.8%) with follow-up CT or endoscopy. There was no rebleeding after the procedure. There was no procedure-related mortality. CONCLUSION: BRTO using STS liquid can be a safe and useful treatment option in patients with gastric varices.

A Case of Linear Digital Mucous Cyst Successfully Treated with 1% Sodium Tetradecyl Sulfate Intralesional Proximal End Injection / 대한피부과학회지

No abstract available.

Utility of sodium tetradecyl sulfate sclerotherapy from benign oral vascular lesion / 대한악안면성형재건외과학회지

BACKGROUND: Hemangioma and vascular malformation are benign vascular lesions that often occur in cephalic and cervical region. Currently, surgical resection, laser therapy, angiographic embolization, use of steroids, and sclerotherapy are used as treatments. CASE PRESENTATION: This study reports three cases of benign vascular lesions that are remarkably treated by sodium tetradecyl sulfate (STS) injection, of which occurred in oral cavity and around the mouth. Three percent of STS was diluted with 0.9 % of normal saline, and it was injected to the lesion site at least once. The result of treatment was evaluated based on clinical findings. CONCLUSION: Surgical treatment of hemangioma and vascular malformation occurred in oral cavity is not normally used because of esthetic issues and potential hemorrhage. On the other hand, sclerotherapy using STS is an effective therapy compare to surgical treatment. Despite the number of STS injection was different for each patient, all three patients had reached satisfactory level through the treatment with gradual diminution of lesions.

The Therapeutic Effect of 1% Sodium Tetradecyl Sulfate Sclerotherapy of Pyogenic Granuloma / 대한피부과학회지

BACKGROUND: For the treatment of pyogenic granuloma (PG), surgical excision, electrocautery, and laser therapy have been employed, apart from other methods. Sodium tetradecyl sulfate (STS) sclerotherapy, as a minimally invasive treatment for vascular lesion, is frequently used for vascular malformations with considerable efficacy and safety. However, there have been a few reports about its use in the treatment of PG. OBJECTIVE: This study was conducted to evaluate the efficacy, recurrence, and side effects of sclerotherapy using 1% STS in the treatment of PG. METHODS: We evaluated 72 patients with PG who were treated with 1% STS from January 2008 to December 2014. Sclerotherapy using 1% STS was performed by "blind" intralesional injection without the aid of imaging such as ultrasonography. The results were evaluated by physical examination, photographic evaluation, and the patient's subjective satisfaction, and then they were classified into 3 groups: complete remission, partial remission, and no change. Recurrence and side effects were also evaluated. RESULTS: Complete remission of PG was achieved in 65 (90.3%) of patients after 1.23 average sessions (range, 1~5 sessions). The remaining patients showed partial remission, with no instances of the treatment resulting in no change. One case of recurrence (1.4%) from partial remission group was seen after 3 months. Clinically, side effects such as pain, tenderness, hyperpigmentation, ulcer, numbness, scarring, and hair loss patches were noted in 18 (25%) patients, but these were all mild and transient. CONCLUSION: 1% STS sclerotherapy can be recommended as an effective therapeutic modality for the treatment of PG with insignificant adverse effects and low recurrence rate.

Three Cases of Digital Mucous Cyst Treated with Sodium Tetradecyl Sulfate Sclerotherapy / 대한피부과학회지

A digital mucous cyst is a benign, non-inflammatory disease frequently observed on the dorsal aspect of the fingers and toes. Multiple punctures with extraction of the cyst contents and intralesional steroid injections are the suggested treatments. However, this approach has shown a high failure and recurrence rate. Cryotherapy has had a better success rate but it is a more painful procedure. Surgical excision of the communicating tract between the cyst and joint has been reported to have the highest cure rate but it requires highly skilled surgery, and the surgery has the risk of severe complications including contractures of the joints and acquired nail deformity. We report three patients with digital mucous cysts treated by sclerotherapy without complications.

The Effect of 0.5% Sodium Tetradecyl Sulfate on a Venous Lake Lesion

BACKGROUND: A venous lake lesion is a venous ectasia that occurs on the exposed skin of elderly people. Although a number of therapies such as surgical excision, laser therapy, infrared coagulation, cryotherapy and sclerotherapy have been used to treat venous lakes, there is no guideline for treating this lesion. OBJECTIVE: The purpose of this study was to determine whether 0.5% sodium tetradecyl sulfate (STS) is effective for the treatment of venous lake lesions. METHODS: Twelve patients with venous lake lesions were enrolled In this study. After proper antiseptic preparation, 0.5% STS was slowly injected into each subject's lesion, and this was followed by immediate compression for 10 minutes. RESULTS: After treatment, all of the patients' lesions cleared completely. The average number of treatments was 2.15+/-1.28. Two patients experienced mild side effects such as light pain and paresthesia, and these soon disappeared. There were no serious side effects reported during treatment. The mean follow up period was 29.58+/-13.48 months. CONCLUSION: We have demonstrated that sclerotherapy with 0.5% STS was quite effective for treating venous lake lesions, and this treatment caused no serious adverse effects.

Therapeutic Effect of Sclerotherapy on Venous Malformations / 대한피부과학회지

BACKGROUND: Although surgical excision is the standard method for the treatment of venous malformations, this procedure often leads to massive bleeding and cosmetic problems. Sclerotherapy for venous malformations has recently been reported, whereas sclerotherapy for varicose veins, leg telangiectasias and hemorrhoids has well been established. PBJECTIVE: To assess the usefulness of sclerotherapy for venous malformations. METHOD: Fourteen patients who had venous malformation were treated with sclerotherapy using sodium tetradecyl sulfate (Thromboject(R), Omega Laboratories, Ltd., Montreal, Canada). Clinical efficacy was evaluated by physical examination and comparison of photographs. RESULTS: In patients with venous malformations, 71.4% of the eases showed moderate to marked improvement. Side effects were noted in 6 patients, however, they were trivial and transient and no treatment was needed. CONCLUSION: Sclerotherapy can be recommended as an effective method for the treatment of venous malformations. It has milder and fewer side effects than other treatment modalities, and it also yields superior cosmetic results.