Written by Hratch L Karamanoukian MD FACS DABS DABTS RVT RPhS RPVI DABVLM
An interesting and novel research paper was presented at UIP 2022 in Istanbul, Turkey regarding the use of autologous gel (Platelet Rich Plasma, PRP) for sclerotherapy of reticular veins, spider veins and telangiectating matting. The research was presented by Dr Yerik Burumkolov and coleagues from Kazakhstan and the Russian Federation.
There are many classes of sclerosant solutions that have been used over 70 years for sclerotherapy, including osmotic agents, detergent class agents and chemical agents like glycerin, among others. These authors have used autologous plasma to effectively treat reticular veins, spider veins and telangiectatic matting using a new class of "solution", namely autologous serum, PRP.
The reasons for using this new sclerosant is that the "side effects and complications of sclerotherapy including hyperpigmentation, telangiectatic matting, skin necrosis and thromboplebitis can lead to patient disstisfaction" accrding to the authors.
The authors studied the use of autologous plasma gel (APG) in 75 patients and studies the outcome over the course of 24 months, APG was prepared from the patient's blood (autologous) by using Plasmolifting technology in anticoagulant containing tubes and APG was injected into target veins and Class 1 compression stockings used for 2 weeks after the sclerotherapy session.
Outcomes were meaured at predetermined times, namely 2, 4, 6 and 8 weeks after treatment.
The authors show complete disappeaance of target vessels after 1 session of APG sclerotherapy in 74.7% of patients,
In 25.3% of patients, a second session was required.
The authors noted no skin hyperpigmentation, skin necrosis, thrombophlebitis in any of the study patients.
Conclusions: The authors conclude that reticular veins, spider veins and telangiectasis with the use of autologous plasma gel is safe and effective and can be an alternative to traditional liquid sclerotherapy and foam sclerotherapy using detergents, osmotic agents or other chemicals.
COMMENTS: This is a novel study that introducs a new class of sclerotherapy agent for use in patients with spider veins, reticular veins and telangiectatic matting. It may prove to be useful in a large body of pateints who are allergic or sensitive to different chemicals and shows promise in treating the most challenging cases where telangiectatic matting occurrs after sclerotherapy. The study needs to be validated.
CITATION: Autologous plasma gel as a sclerosing agent in tretament of reticular veins and telangiectasias of the lower extremities. Yerik Burumkulov, Tokan Sultanaliyev, Evgeny Shaidakov, Serik Tursynbayev, Abdimazhit Bespayev and Askhat Sharipoc. UIP 2022, Istanbul Turkey.