AB067. SOH23ABS_182. Sodium tetradecyl sulphate vs. polidocanol: identifying the ideal sclerosant agent

Background: Sclerosant agents are used as an effective therapeutic modality for varicose veins both as foam and in mechanochemical ablation (MOCA). With no published randomized trials comparing sclerosant agents the aim of this study was to compare varicose vein recurrence rates and complications between two sclerosants: polidocanol (POL) and sodium tetradecyl sulphate (STS).

Methods: We performed a retrospective review of all patients who underwent varicose vein treatment between September 2015 and September 2016. Operative logs and patient records were searched to gather baseline patient characteristics. The primary outcome was recurrence at any time. Secondary outcomes included recurrence, representation to clinic, phlebitis, hard lumps, brown staining, deep veins thrombosis (DVT), pulmonary embolism (PE), and overall patient satisfaction.

Results: In the study period 425 patients were treated with sclerosant: 210 with POL and 215 with STS. Recurrence rate was 43% in POL and 25% in STS (P=0.001). Further breakdown by sex showed recurrence of 41% in females vs. 53% in males with POL, and 27% female vs. 32% males with STS. Complications of hard lumps (4.2% POL, 2.3% STS, P=0.257), phlebitis (1.9% POL, 2.7% STS, P=0.547), brown staining (1.9% POL, 1.8% STS, P=0.973), and DVT/PE (0% POL, 0.9% STS) were not significantly different between groups. The overall satisfaction rates were 51% with POL and 69% with STS (P=0.0001).

Conclusions: The use of STS is associated with a significantly lower rate of recurrence and higher satisfaction rates than POL. There was no significant difference in complication rates between groups. We recommend the use of STS when using foam to treat varicose veins.

Keywords: Sclerosant; sodium tetradecyl sulphate (STS); polidocanol (POL); varicose veins; mechanochemical ablation (MOCA)