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LIPIODOL reduces the lytic activity of detergent sclerosants in vitro
Joseph Gracé1,2, David Connor1,2, Lourens Bester3
1Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research (AMR), St. Vincent's Hospital, Sydney, Australia.
Insights
Mixing LIPIODOL with sclerosant detergents significantly reduces their lytic activity. This interaction impacts the potency of sclerosants, particularly at lower concentrations, affecting vascular anomaly treatments.
Area of Science:
- Interventional Radiology
- Vascular Medicine
- Biochemistry
Background:
- Contrast agents are vital in interventional radiology, especially for vascular anomalies.
- Sclero-embolic agents are frequently used with contrast agents.
- Limited data exists on the interaction between contrast and sclerosant agents when mixed.
Purpose of the Study:
- To investigate the in vitro interaction between radiological contrast agents and detergent sclerosants.
- To quantify the effect of mixing on the lytic activity and potency of detergent sclerosants.
Main Methods:
- Assessed red blood cell lysis after incubating contrast agents (LIPIODOL, ULTRAVIST) with detergent sclerosants (sodium tetradecyl sulfate - STS, polidocanol - POL).
- Evaluated the miscibility and density differences between agents.
Main Results:
- LIPIODOL caused cell lysis; ULTRAVIST did not.
- Neither STS nor POL were miscible in LIPIODOL.
- Mixing LIPIODOL with STS or POL reduced sclerosant lytic activity, requiring higher concentrations for 50% cell lysis.
Conclusions:
- LIPIODOL significantly reduces the lytic activity of detergent sclerosants when mixed (1:1 ratio).
- This reduction in potency is most pronounced at lower sclerosant concentrations.
- Findings highlight the importance of understanding agent interactions in clinical practice.
Objectives:
Contrast agents are used widely in the interventional setting and in particularly in the management of vascular anomalies and have also been used in combination with sclero-embolic agents. There is limited information on the interaction of contrast agents with sclerosant agents when used as mixtures. The aim of this study was to determine the effect of mixing radiological contrast agents with detergent sclerosants and measuring the effect on change in lytic activity of detergent sclerosants in vitro and by proxy the change in potency.
Methods:
Red blood cell lysis was assessed following the incubation of two commonly used contrast agents, LIPIODOL® and ULTRAVIST®, mixed with detergent sclerosants, FIBROVEIN®, sodium tetradecyl sulfate (STS), and AETHOXYSKLEROL®, polidocanol (POL).
Results:
The density of both contrast agents was higher than STS and POL and neither of the detergent sclerosants were miscible in LIPIODOL. LIPIODOL on its own caused cell lysis (1.01%, p < 0.05) whereas ULTRAVIST did not. Fifty per cent cell lysis for sclerosant and LIPIODOL mix occurred at concentrations of: 0.041% (2.4 times greater than the control, p < 0.05) and 0.08% (3.6 times greater than the control, p = 0.06) for STS and POL, respectively.
Conclusions:
LIPIODOL, when mixed with sclerosant detergents (ratio 1:1) causes a reduction in the lytic activity of sclerosants and this effect was statistically significant and most prominent in lower sclerosant concentration mixtures.
