1
|
Patel ND, Chong AT, Kolla AM, Mabud TS, Kulkarni K, Masrouha K, Taslakian B, Bertino FJ. Venous Malformations. Semin Intervent Radiol 2022; 39:498-507. [PMID: 36561936 PMCID: PMC9767763 DOI: 10.1055/s-0042-1757940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Venous malformations, the most common type of vascular malformation, are slow-flow lesions resulting from disorganized angiogenesis. The International Society for the Study of Vascular Anomalies (ISSVA) classification offers a categorization scheme for venous malformations based on their genetic landscapes and association with congenital overgrowth syndromes. Venous malformations present as congenital lesions and can have broad physiologic and psychosocial sequelae depending on their size, location, growth trajectory, and tissue involvement. Diagnostic evaluation is centered around clinical examination, imaging evaluation with ultrasound and time-resolved magnetic resonance imaging, and genetic testing for more complex malformations. Interventional radiology has emerged as first-line management of venous malformations through endovascular treatment with embolization, while surgery and targeted molecular therapies offer additional therapeutic options. In this review, an updated overview of the genetics and clinical presentation of venous malformations in conjunction with key aspects of diagnostic imaging and treatment are discussed.
Collapse
Affiliation(s)
- Nihal D. Patel
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Anthony T. Chong
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Avani M. Kolla
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Tarub S. Mabud
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Kopal Kulkarni
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Karim Masrouha
- Department of Orthopedic Surgery, NYU Grossman School of Medicine, New York, New York
| | - Bedros Taslakian
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
| | - Frederic J. Bertino
- Division of Vascular and Interventional Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, New York
- Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| |
Collapse
|
2
|
Pullano SA, Marcianò G, Bianco MG, Oliva G, Rania V, Vocca C, Cione E, De Sarro G, Gallelli L, Romeo P, La Gatta A, Fiorillo AS. FT-IR Analysis of Structural Changes in Ketoprofen Lysine Salt and KiOil Caused by a Pulsed Magnetic Field. Bioengineering (Basel) 2022; 9:bioengineering9100503. [PMID: 36290471 PMCID: PMC9598906 DOI: 10.3390/bioengineering9100503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
High-intensity, low-frequency magnetic fields (MFs) have been widely used in the treatment of diseases and in drug delivery, even though they could induce structural changes in pharmacological molecules. Morphological changes in ketoprofen and KiOil were investigated through Fourier-transform infrared spectroscopy (FT-IR). Unsupervised principal component analysis was carried out for data clustering. Clinical validation on 22 patients with lower back pain was managed using diamagnetic therapy plus topical ketoprofen or KiOil. The Numerical Rating Scale (NRS) and Short-Form Health Survey 36 (SF-36) were used to evaluate clinical and functional response. Ketoprofen showed clear clustering among samples exposed to MF (4000−650 cm−1), and in the narrow frequency band (1675−1475 cm−1), results evidenced structural changes which involved other excipients than ketoprofen. KiOil has evidenced structural modifications in the subcomponents of the formulation. Clinical treatment with ketoprofen showed an average NRS of 7.77 ± 2.25 before and an average NRS of 2.45 ± 2.38 after MF treatment. There was a statistically significant reduction in NRS (p = 0.003) and in SF-36 (p < 0.005). Patients treated with KiOil showed an average NRS of 7.59 ± 2.49 before treatment and an average NRS of 1.90 ± 2.26 after treatment (p < 0.005). SF-36 showed statistical significance for all items except limitations due to emotional problems. A high-intensity pulsed magnetic field is an adjunct to topical treatment in patients with localized pain, and the effect of MF does not evidence significant effects on the molecules.
Collapse
Affiliation(s)
- Salvatore Andrea Pullano
- BATS Laboratory, Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Gianmarco Marcianò
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Sciences, “Magna Græcia” University of Catanzaro, Mater Domini Hospital, 88100 Catanzaro, Italy
| | - Maria Giovanna Bianco
- Department of Surgical and Medical Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Giuseppe Oliva
- BATS Laboratory, Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Vincenzo Rania
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Sciences, “Magna Græcia” University of Catanzaro, Mater Domini Hospital, 88100 Catanzaro, Italy
| | - Cristina Vocca
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Sciences, “Magna Græcia” University of Catanzaro, Mater Domini Hospital, 88100 Catanzaro, Italy
| | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018–2022, University of Calabria, Ed. Polifunzionale, Arcavacata di Rende, 87036 Rende, Italy
- GalaScreen Laboratories, University of Calabria, Ed. Polifunzionale, Arcavacata di Rende, 87036 Rende, Italy
- Medifarmagen SRL, University of Catanzaro, 88100 Catanzaro, Italy
| | - Giovambattista De Sarro
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Sciences, “Magna Græcia” University of Catanzaro, Mater Domini Hospital, 88100 Catanzaro, Italy
- FAS@UMG Research Center, Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Luca Gallelli
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Sciences, “Magna Græcia” University of Catanzaro, Mater Domini Hospital, 88100 Catanzaro, Italy
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018–2022, University of Calabria, Ed. Polifunzionale, Arcavacata di Rende, 87036 Rende, Italy
- GalaScreen Laboratories, University of Calabria, Ed. Polifunzionale, Arcavacata di Rende, 87036 Rende, Italy
- Medifarmagen SRL, University of Catanzaro, 88100 Catanzaro, Italy
- FAS@UMG Research Center, Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Pietro Romeo
- Department of Orthopedics, Istituto di Ricovero E Cura A Carattere Scientifico, Istituto Ortopedico Galeazzi, 20123 Milan, Italy
| | - Antonio La Gatta
- BATS Laboratory, Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
| | - Antonino S. Fiorillo
- BATS Laboratory, Department of Health Sciences, “Magna Græcia” University of Catanzaro, 88100 Catanzaro, Italy
- Correspondence:
| |
Collapse
|
3
|
Bai T, Jiang W, Liang L, Li Y, Fan Y. An Optical Method for Immediate Evaluation of Microfoam Stability in Foam Sclerotherapy. Skin Pharmacol Physiol 2021; 34:128-134. [PMID: 33794544 DOI: 10.1159/000514322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 01/10/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The objective of our study was to develop an optical method that instantly evaluates the stability of sclerosing foam, which would enable early predictions of the clinical performance of the foam and reduce the occurrence of clinical side effects. METHODS Based on the principle of light scattering, we developed a method to optically test foam stability and verified it experimentally using sodium morrhuate (2 mL; 0.05 g/mL) and carbon dioxide. A self-made foam preparation instrument was used to achieve a preparation speed of 275 mm/s. The liquid-gas ratios were considered as 1:3, 1:4, and 1:5. Curves of illuminance with respect to the drainage rate and decay time were obtained. By fitting the curve, the relationship between foam half-life time (FHT) and foam decay was obtained. Thus, foam stability was evaluated using the initial illuminance value; the foam transfer time was approximately 3 s. RESULTS The experimental FHT varies between 205 and 232 s. Illuminance is exponentially related to drainage rate and linearly related with time. FHT can be expressed by the initial illuminance and illuminance curve fitting coefficients. The half-life of the foam decreases as the initial illuminance value increases, for the same sclerosing drug. The suitability of foam stability is determined by the position of the initial value in the chart. CONCLUSION Optical methods are feasible for evaluating foam stability over a short period of time. Clinically predicting the stability of freshly prepared foam can reduce number of incidences of further complications. This will promote the development of foam sclerotherapy and provide a basic understanding of the internal mechanical properties of foam.
Collapse
Affiliation(s)
- Taoping Bai
- Department of Applied Mechanics, Sichuan University, Chengdu, China
| | - Wentao Jiang
- Department of Applied Mechanics, Sichuan University, Chengdu, China
| | - Lin Liang
- School of Civil Engineering, Southwest Jiaotong University, Chengdu, China
| | - Yalan Li
- Department of Applied Mechanics, Sichuan University, Chengdu, China
| | - Yubo Fan
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| |
Collapse
|
4
|
Skuła M, Hobot J, Czaja J, Simka M. The effect of the calibre and length of needle on the stability of sclerosing foam. Phlebology 2020; 36:322-328. [PMID: 33236673 DOI: 10.1177/0268355520953317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Little is known how calibre and length of needles affect the stability of sclerosing foam. METHODS Foams were made of 0.5%, 1%, 2% and 3% polidocanol, and 0.2%, 0.5%, 1% and 3% sodium tetradecyl sulfate (STS), which were mixed with air in the proportion of 4:1. These foams were ejected through needles with the length of: 4 mm, 6 mm and 13 mm, and diameter of: 0.26 mm, 0.3 mm and 0.4 mm. RESULTS Foams made of more concentrated polidocanol were more stable. Regarding STS an opposite relationship was revealed. Foams made of polidocanol were more stable if ejected through a longer needle, while the length of needle did not significantly affect stability of STS foams. Foams ejected through 0.26 mm diameter needles were very unstable. In the case of 0.5% polidocanol, 0.3x6mm needle provided atypically stable foam. CONCLUSION In order to inject maximally stable foam, calibre and length of needle should be taken into account.
Collapse
Affiliation(s)
- Marcin Skuła
- Department of Anatomy, University of Opole, Opole, Poland
| | - Jacek Hobot
- Department of Anatomy, University of Opole, Opole, Poland
| | - Joanna Czaja
- Department of Anatomy, University of Opole, Opole, Poland
| | - Marian Simka
- Department of Anatomy, University of Opole, Opole, Poland
| |
Collapse
|
5
|
Critello DC, Pullano SA, Gallo G, Matula TJ, Fiorillo AS. Low frequency ultrasound as a potentially viable foaming option for pathological veins. Colloids Surf A Physicochem Eng Asp 2020. [DOI: 10.1016/j.colsurfa.2020.124919] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
6
|
Meghdadi A, Jones SA, Patel VA, Lewis AL, Millar TM, Carugo D. Foam-in-vein: A review of rheological properties and characterization methods for optimization of sclerosing foams. J Biomed Mater Res B Appl Biomater 2020; 109:69-91. [PMID: 32621565 DOI: 10.1002/jbm.b.34681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/04/2020] [Accepted: 06/16/2020] [Indexed: 12/19/2022]
Abstract
Varicose veins are chronic venous defects that affect >20% of the population in developed countries. Among potential treatments, sclerotherapy is one of the most commonly used. It involves endovenous injection of a surfactant solution (or foam) in varicose veins, inducing damage to the endothelial layer and subsequent vessel sclerosis. Treatments have proven to be effective in the short-term, however recurrence is reported at rates of up to 64% 5-year post-treatment. Thus, once diagnosed with varicosities there is a high probability of a permanently reduced quality of life. Recently, foam sclerotherapy has become increasingly popular over its liquid counterpart, since foams can treat larger and longer varicosities more effectively, they can be imaged using ultrasound, and require lower amounts of sclerosing agent. In order to minimize recurrence rates however, an investigation of current treatment methods should lead to more effective and long-lasting effects. The literature is populated with studies aimed at characterizing the fundamental physics of aqueous foams; nevertheless, there is a significant need for appropriate product development platforms. Despite successfully capturing the microstructural evolution of aqueous foams, the complexity of current models renders them inadequate for pharmaceutical development. This review article will focus on the physics of foams and the attempts at optimizing them for sclerotherapy. This takes the form of a discussion of the most recent numerical and experimental models, as well as an overview of clinically relevant parameters. This holistic approach could contribute to better foam characterization methods that patients may eventually derive long term benefit from.
Collapse
Affiliation(s)
- Alireza Meghdadi
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | | | | | | | | | - Dario Carugo
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK.,Institute for Life Sciences (IfLS), University of Southampton, Southampton, UK
| |
Collapse
|
7
|
Connor DE, Gerbelli J, Chew AN, Cooley-Andrade O, Goonawardhana D, Cheung K, Parsi K. Sirolimus and propranolol inhibit endothelial proliferation while detergent sclerosants induce endothelial activation, microparticle release and apoptosis in vitro. Phlebology 2020; 35:566-575. [PMID: 32216526 DOI: 10.1177/0268355520913384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the effects of detergent sclerosants, sodium tetradecyl sulphate and polidocanol, on endothelial cell activation and microparticle release and the effects of detergent sclerosants, sirolimus and propranolol, on apoptosis in vitro. METHODS Cultured human umbilical vein endothelial cells and murine haemangioendothelioma (EOMA) cell lines were incubated with different concentrations of sodium tetradecyl sulphate and polidocanol, as well as sirolimus and propranolol. Endothelial activation was assessed using flow cytometry for CD62e (E-Selectin), CD54 (ICAM-1), CD105 (endoglin), CD144 (VE-Cadherin), CD146 (MCAM) and the release of endothelial microparticles. Cell proliferation was assessed using [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] and carboxyfluorescein succinimidyl ester assays. Apoptosis was assessed using flow cytometry for lactadherin/propidium iodide staining and for Caspase-3 expression. RESULTS Sublytic concentrations of sodium tetradecyl sulphate and polidocanol (0.075%-0.3%) increased the expression of the activation markers CD62e and CD54. The expression of CD105 decreased in sclerosant treated cultured human umbilical vein endothelial cells. Both sodium tetradecyl sulphate and polidocanol induced the release of endothelial microparticles. All agents inhibited cell proliferation. Sodium tetradecyl sulphate and polidocanol-induced apoptosis as evidenced by increased phosphatidylserine exposure and caspase-3 expression, whereas sirolimus and propranolol increased caspase-3 expression only. CONCLUSION Sublytic concentrations of detergent sclerosants induce endothelial activation and the release of endothelial microparticles. All agents were anti-proliferative in EOMA cell lines, with sodium tetradecyl sulphate and polidocanol inducing cellular apoptosis.
Collapse
Affiliation(s)
- David E Connor
- Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St. Vincent's Centre for Applied Medical Research, St. Vincent's Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Jessica Gerbelli
- Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St. Vincent's Centre for Applied Medical Research, St. Vincent's Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia.,Centro Universitário Barão de Mauá, Ribeirão Preto, Brazil
| | - An-Ning Chew
- Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St. Vincent's Centre for Applied Medical Research, St. Vincent's Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Osvaldo Cooley-Andrade
- Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St. Vincent's Centre for Applied Medical Research, St. Vincent's Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Dulani Goonawardhana
- Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St. Vincent's Centre for Applied Medical Research, St. Vincent's Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Kelvin Cheung
- Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St. Vincent's Centre for Applied Medical Research, St. Vincent's Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Kurosh Parsi
- Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St. Vincent's Centre for Applied Medical Research, St. Vincent's Hospital, Sydney, Australia.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| |
Collapse
|
8
|
|
9
|
Critello CD, Pullano SA, Matula TJ, De Franciscis S, Serra R, Fiorillo AS. Recent developments on foaming mechanical and electronic techniques for the management of varicose veins. Expert Rev Med Devices 2019; 16:931-940. [PMID: 31622557 DOI: 10.1080/17434440.2019.1682549] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Introduction: Varicose veins are a common disease, causing significant impairment of quality of life to afflicted individuals. Conventional surgery has represented the traditional treatment for years, with significant post-operative complications. By the end of the 20th century, novel approaches had been developed to induce biochemical sclerosis into the treated vein in order to exclude it from blood circulation.Areas covered: Foaming techniques for treatment of varicose veins, both clinically-approved methods and those under experimental studies. A brief description of cavitation, which is the basis of microbubbles formation, and an overview of foam properties have been also provided, including a discussion on clinical efficacy and safety profile.Expert commentary: Foam sclerotherapy has rapidly gained popularity since it represents the most minimally invasive and cost-effective procedure in the short term. Several different methods of foam preparation have been described in literature. In general, the foam generation method may affect characteristics such as stability and bubble size distribution, which in turn affect the therapeutic action of foam itself. Therefore, the selection of a suitable foaming technique is of importance for treatment success. Future developments on foaming techniques are expected to make sclerotherapy, already an effective treatment, even safer and more versatile therapeutic procedure.
Collapse
Affiliation(s)
- C Davide Critello
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Salvatore A Pullano
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Thomas J Matula
- Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Stefano De Franciscis
- Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Raffaele Serra
- Department of Surgical and Medical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Antonino S Fiorillo
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| |
Collapse
|
10
|
Hawkins CM, Chewning RH. Diagnosis and Management of Extracranial Vascular Malformations in Children: Arteriovenous Malformations, Venous Malformations, and Lymphatic Malformations. Semin Roentgenol 2019; 54:337-348. [PMID: 31706367 DOI: 10.1053/j.ro.2019.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- C Matthew Hawkins
- Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA; Division of Pediatric Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Emory + Children's Pediatric Institute, Children's Healthcare of Atlanta at Egleston, Atlanta, GA.
| | - Rush H Chewning
- Division of Vascular and Interventional Radiology, Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| |
Collapse
|
11
|
Bottaro E, Paterson J, Zhang X, Hill M, Patel VA, Jones SA, Lewis AL, Millar TM, Carugo D. Physical Vein Models to Quantify the Flow Performance of Sclerosing Foams. Front Bioeng Biotechnol 2019; 7:109. [PMID: 31165068 PMCID: PMC6536569 DOI: 10.3389/fbioe.2019.00109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 05/01/2019] [Indexed: 11/13/2022] Open
Abstract
Foam sclerotherapy is clinically employed to treat varicose veins. It involves intravenous injection of foamed surfactant agents causing endothelial wall damage and vessel shrinkage, leading to subsequent neovascularization. Foam production methods used clinically include manual techniques, such as the Double Syringe System (DSS) and Tessari (TSS) methods. Pre-clinical in-vitro studies are conducted to characterize the performance of sclerosing agents; however, the experimental models used often do not replicate physiologically relevant physical and biological conditions. In this study, physical vein models (PVMs) were developed and employed for the first time to characterize the flow behavior of sclerosing foams. PVMs were fabricated in polydimethylsiloxane (PDMS) by replica molding, and were designed to mimic qualitative geometrical characteristics of veins. Foam behavior was investigated as a function of different physical variables, namely (i) geometry of the vein model (i.e., physiological vs. varicose vein), (ii) foam production technique, and (iii) flow rate of a blood surrogate. The experimental set-up consisted of a PVM positioned on an inclined platform, a syringe pump to control the flow rate of a blood substitute, and a pressure transducer. The static pressure of the blood surrogate at the PVM inlet was measured upon foam administration. The recorded pressure-time curves were analyzed to quantify metrics of foam behavior, with a particular focus on foam expansion and degradation dynamics. Results showed that DSS and TSS foams had similar expansion rate in the physiological PVM, whilst DSS foam had lower expansion rate in the varicose PVM compared to TSS foam. The degradation rate of DSS foam was lower than TSS foam, in both model architectures. Moreover, the background flow rate had a significant effect on foam behavior, enhancing foam displacement rate in both types of PVM.
Collapse
Affiliation(s)
- Elisabetta Bottaro
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Jemma Paterson
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Xunli Zhang
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences (IfLS), University of Southampton, Southampton, United Kingdom
| | - Martyn Hill
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Venisha A Patel
- Biocompatibles UK Ltd. (a BTG group company), Camberley, United Kingdom
| | - Stephen A Jones
- Biocompatibles UK Ltd. (a BTG group company), Camberley, United Kingdom
| | - Andrew L Lewis
- Biocompatibles UK Ltd. (a BTG group company), Camberley, United Kingdom
| | - Timothy M Millar
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Dario Carugo
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom.,Institute for Life Sciences (IfLS), University of Southampton, Southampton, United Kingdom
| |
Collapse
|
12
|
Cilurzo F, Critello CD, Paolino D, Fiorillo AS, Fresta M, De Franciscis S, Celia C. Polydocanol foam stabilized by liposomes: Supramolecular nanoconstructs for sclerotherapy. Colloids Surf B Biointerfaces 2018; 175:469-476. [PMID: 30572155 DOI: 10.1016/j.colsurfb.2018.12.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 02/07/2023]
Abstract
Vascular pathology of the lower limbs is a widespread disease affecting the quality of life for more than 30% of the adult world population. Polydocanol foam is presently the main therapeutic option for treating varicosities, inflammation, and chronic disease which affect the vascular endothelium and blood vessels. Unfortunately, the commercial product contains detergents and surfactants which can provoke several side effects and decrease the efficacy of therapy. In an attempt to overcome these drawbacks, polydocanol foam was mixed with different liposomes before use. The resulting mixture was stable and generated supramolecular nanoconstructs, which may prevent the interaction of the components of the commercial polydocanol foam with the vascular endothelium. This effect depends on the presence of liposomes, which can induce polydocanol foam to change its structure from micelles to complex nanostructures, thus improving its stability. In this attempt, the physicochemical features of the resulting nanoconstructs were tested through dynamic- and multiple light scattering analyses, rheological studies and gel permeation chromatography, while the stability was tested in biological fluids. Our preliminary results showed that the nanoconstructs have some potential as therapeutic agents in sclerotherapy.
Collapse
Affiliation(s)
- Felisa Cilurzo
- Department of Pharmacy, University of Chieti - Pescara "G. d'Annunzio", Chieti, Italy
| | | | - Donatella Paolino
- Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Græcia", Catanzaro, Italy; IRC-FSH-Interregional Research Center for Food Safety & Health, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | | | - Massimo Fresta
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy; IRC-FSH-Interregional Research Center for Food Safety & Health, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Stefano De Franciscis
- Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Christian Celia
- Department of Pharmacy, University of Chieti - Pescara "G. d'Annunzio", Chieti, Italy; Department of Nanomedicine, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX, 77030, USA.
| |
Collapse
|
13
|
Bai T, Chen Y, Jiang W, Yan F, Fan Y. Studies on Foam Decay Trend and Influence of Temperature Jump on Foam Stability in Sclerotherapy. Vasc Endovascular Surg 2017; 52:98-106. [DOI: 10.1177/1538574417741786] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: This study investigated the influence of temperature jump and liquid–gas ratio on foam stability to derive the foam-decay law. Methods: The experimental group conditions were as follows: mutation temperatures (10°C, 16°C, 20°C, 23°C, 25°C, and 27°C to >37°C) and liquid–gas ratios (1:1, 1:2, 1:3, and 1:4). The control group conditions were as follows: temperatures (10°C, 16°C, 20°C, 23°C, 25°C and 27°C) and liquid–gas ratios (1:1, 1:2, 1:3, and 1:4). A homemade device manufactured using the Tessari DSS method was used to prepare the foam. The decay process was videotape recorded. In the drainage rate curve, the temperature rose, and the liquid–gas ratio varied from 1:1 to 1:4, causing faster decay. Results: In the entire process, the foam volume decreased with increasing drainage rate. The relationships were almost linear. Comparison of the experimental and control groups shows that the temperature jump results in a drainage time range of 1 to 15 seconds. The half-life ranges from 10 to 30 seconds. The maximum rate is 18.85%. Changes in the preparation temperature yields a drainage time range of 3 to 30 seconds. The half-life varies from 20 to 60 seconds. Conclusion: Decreasing the temperature jump range and liquid–gas ratio gradually enhances the foam stability. The foam decay time and drainage rate exhibit an exponential function distribution.
Collapse
Affiliation(s)
- Taoping Bai
- Department of Applied Mechanics, Sichuan University, Chengdu, China
| | - Yu Chen
- Department of Applied Mechanics, Sichuan University, Chengdu, China
| | - Wentao Jiang
- Department of Applied Mechanics, Sichuan University, Chengdu, China
| | - Fei Yan
- Department of Applied Mechanics, Sichuan University, Chengdu, China
| | - Yubo Fan
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| |
Collapse
|