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How does Polidochanol work for sclerotherapy ?

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    How does Polidochanol work ? 

    Hratch Karamanoukian MD FACS RVT RPVI RPhS DABVLM

    Polidochanol is a non-ionic sclerosant in the non-ionic detergent class of sclerosant solutions.  

    It has local anesthetic action, meaning that it has properties that allow it to dull the pain sensation upon injection. 

    How does Polidochanol work ?

    Polidochanol causes a "chemical burn" insde the injected vein, namely causing injury to the inside lining of the vein, the endothelium. 

    What is the direct mechanism of action of Polidochanol ? 

    Polidochanol solubilizes the lipoprotein components of the vessel wall.  Lipoproteins are found in the walls of arterial and venous structures.  Once the lipoproteins are destroyed, Polidocahnol creates local vein wall inflammation which is 
    followed by fibrosis (or thickening) of the vein wall and ultimate closure or obliteration of the injected vein between 6-8 weeks after therapy. 

    What happens after fibrosis of the vein wall that has been injected with Polidochanol ? 

    After a period of fibrosis, there is a healing process over months which provides the cosmetic outcome that is sought with the sclerotherapy. 

    What is the maximum accepted dose for Polidochanol ? 

    2 mg/Kg/day

    How is Polidochanol injectged ? 

    Both Polidochanol foam and Polidochanol liquid forms are acceptable methods of injection during sclerotehrapy. 

    About the author:  Dr Karamanoukian is Board Certified in Surgery (American Board of Surgery) and Cardiovascular Surgery (American Board of Thoracic Surgery).  He is a Senior Member of the American Vein and Lymphatic Society and 
    has Certification from the American Board of Venous and Lymphatic Medicine (ABVLM).  He is a Diplomate of the ABVLM.  He has added certification as an RVT (Registered Vascular Technology), RPVI, and RPhS.   

    You can read his board review book for RPhS Certification Examination on www.PhlebologyExam.com