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Benefits of polidocanol endovenous microfoam (Varithena®) compared with physician-compounded foams

Carugo, D; Ankrett, DN; Zhao, X; Zhang, X; Hill, M; O'Byrne, V; Hoad, J; ... Lewis, AL; + view all (2016) Benefits of polidocanol endovenous microfoam (Varithena®) compared with physician-compounded foams. Phlebology , 31 (4) pp. 283-295. 10.1177/0268355515589063. Green open access

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Abstract

Objective: To compare foam bubble size and bubble size distribution, stability, and degradation rate of commercially available polidocanol endovenous microfoam (Varithena) and physician-compounded foams using a number of laboratory tests. Methods: Foam properties of polidocanol endovenous microfoam and physician-compounded foams were measured and compared using a glass-plate method and a Sympatec QICPIC image analysis method to measure bubble size and bubble size distribution, TurbiscanTM LAB for foam half time and drainage and a novel biomimetic vein model to measure foam stability. Physician-compounded foams composed of polidocanol and room air, CO2, or mixtures of oxygen and carbon dioxide (O2:CO2) were generated by different methods. Results: Polidocanol endovenous microfoam was found to have a narrow bubble size distribution with no large (>500 mm) bubbles. Physician-compounded foams made with the Tessari method had broader bubble size distribution and large bubbles, which have an impact on foam stability. Polidocanol endovenous microfoam had a lower degradation rate than any physician-compounded foams, including foams made using room air (p < 0.035). The same result was obtained at different liquid to gas ratios (1:4 and 1:7) for physician-compounded foams. In all tests performed, CO2 foams were the least stable and different O2:CO2 mixtures had intermediate performance. In the biomimetic vein model, polidocanol endovenous microfoam had the slowest degradation rate and longest calculated dwell time, which represents the length of time the foam is in contact with the vein, almost twice that of physician-compounded foams using room air and eight times better than physician-compounded foams prepared using equivalent gas mixes. Conclusion: Bubble size, bubble size distribution and stability of various sclerosing foam formulations show that polidocanol endovenous microfoam results in better overall performance compared with physician-compounded foams. Polidocanol endovenous microfoam offers better stability and cohesive properties in a biomimetic vein model compared to physician-compounded foams. Polidocanol endovenous microfoam, which is indicated in the United States for treatment of great saphenous vein system incompetence, provides clinicians with a consistent product with enhanced handling properties

Type: Article
Title: Benefits of polidocanol endovenous microfoam (Varithena®) compared with physician-compounded foams
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/0268355515589063
Publisher version: https://doi.org/10.1177/0268355515589063
Language: English
Additional information: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed
Keywords: Foam drainage times, foam half time, physician-compounded foams, bubble size, bubble size distribution, varicose veins, polidocanol endovenous microfoam, sclerotherapy, biomimetic analysis method, polidocanol injectable foam
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Pharmaceutics
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10109422
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