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Related Concept Videos

Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Related Experiment Video

Updated: Jun 5, 2025

Combination of High Ligation and Intraoperative Embolization using Polidocanol for Treatment of Varicoceles
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Early experience managing intravascular coagulum using polidocanol endovenous microfoam: Risk factor analysis.

Mariam Mesa-Damiano1, Francisco J Melesio1, Jailenne I Quiñones-Rodriguez1

  • 1Department of Clinical Anatomy, Sam Houston State University College of Osteopathic Medicine, Conroe, TX, USA.

Phlebology
|December 16, 2024
PubMed
Summary

Lower injection volumes of polidocanol endovenous microfoam (PEM) are linked to a higher risk of developing intravascular coagulum (IC). Further research is needed to determine optimal PEM injection volumes for vein treatment.

Keywords:
Intravascular coagulumpolidocanol endovenous microfoamrisk factorssclerotherapy

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Area of Science:

  • Vascular Surgery
  • Phlebology
  • Medical Device Research

Background:

  • Intravascular coagulum (IC) is an observed complication in clinical practice following polidocanol endovenous microfoam (PEM) treatment for chronic venous insufficiency.
  • Identifying risk factors for IC is crucial for improving patient outcomes and treatment protocols.

Purpose of the Study:

  • To investigate potential risk factors associated with the development of intravascular coagulum (IC) after polidocanol endovenous microfoam (PEM) treatment.
  • To analyze patient demographics, comorbidities, and ultrasound findings in relation to IC incidence.

Main Methods:

  • A retrospective cohort study of 119 patients treated with PEM for chronic venous insufficiency.
  • Patients were stratified into IC (n=16) and non-IC (n=103) groups based on clinical presentation and ultrasound-confirmed coagulum aspiration.
  • Demographic data, comorbidities, and duplex ultrasound reports were analyzed.

Main Results:

  • Overall, 13% of patients developed IC, with a mean onset time of 45 days post-ablation.
  • Univariate analysis indicated lower PEM injection volumes, high great saphenous vein (GSV) reflux, and Latino ethnicity as potential risk factors.
  • Multivariate analysis confirmed lower PEM injection volumes as the sole significant risk factor for IC development (p=0.006).

Conclusions:

  • Lower polidocanol endovenous microfoam injection volumes represent a significant risk factor for intravascular coagulum formation.
  • Further studies are warranted to establish ideal injection volumes per treated venous segment to mitigate IC risk.