Comparative stability of sodium tetradecyl sulphate (STD) and polidocanol foam: Impact on vein damage in an in-vitro model

Abstract

Objectives: To compare the half-life of STD and Polidocanol air-based foams and the damage they inflict upon human great saphenous vein in an in-vitro model. Methods: The time for the volume of 3% STD and polidocanol foams to reduce by 10% (T 90) and 50% (T 50) was recorded in an incubator at 37 °C. Segments of proximal GSV harvested during varicose vein surgery were filled with foam for 5 or 15 min. Histological analysis determined percentage endothelial cell loss and depth of media injury. Results: Median (±IQR) T 90 and T 50 for polidocanol were 123.3 s (111.7-165.6) and 266.3 s (245.6-383.1) versus 102.03 s (91.1-112) and 213.13 s (201-231.6) for STD (T 90 p = 0.008, T 50 p = 0.004). Median endothelial loss with polidocanol was; 63.5% (62.2-82.8) and 85.9% (83.8-92.5) versus 86.3% (84.8-93.7) and 97.64% (97.3-97.8) for STD after 5 and 15 min (p = 0.076 and p = 0.009). The median depth and % media thickness injured were 0 μm (0-0 μm) and 0% for both assessments with polidocanol versus 37.4 μm (35.3-45.8 and 43.4 μm (42.1-46.7) and 3.5% (3.1-3.6) and 5.3% (3.7-6.0) after 5 and 15 min for STD (p < 0.01 for all comparisons). Conclusion: Although polidocanol foam shows greater stability than STD foam perhaps remaining in the vein for longer, endothelial cell loss and damage to the media were significantly greater with STD. © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.