Comparative Stability of Sodium Tetradecyl Sulphate (STD) and Polidocanol Foam: Impact on Vein Damage in an In-vitro Model

Abstract Objectives To compare the half-life of STD and Polidocanol air-based foams and the damage they inflict upon human great saphenous vein in an in-vitro model. Methods The time for the volume of 3% STD and polidocanol foams to reduce by 10% ( T 90 ) and 50% ( T 50 ) was recorded in an incubator at 37 °C. Segments of proximal GSV harvested during varicose vein surgery were filled with foam for 5 or 15 min. Histological analysis determined percentage endothelial cell loss and depth of media injury. Results Median (±IQR) T 90 and T 50 for polidocanol were 123.3 s (111.7–165.6) and 266.3 s (245.6–383.1) versus 102.03 s (91.1–112) and 213.13 s (201–231.6) for STD ( T 90 p  = 0.008, T 50 p  = 0.004). Median endothelial loss with polidocanol was; 63.5% (62.2–82.8) and 85.9% (83.8–92.5) versus 86.3% (84.8–93.7) and 97.64% (97.3–97.8) for STD after 5 and 15 min ( p  = 0.076 and p  = 0.009). The median depth and % media thickness injured were 0 μm (0–0 μm) and 0% for both assessments with polidocanol versus 37.4 μm (35.3–45.8 and 43.4 μm (42.1–46.7) and 3.5% (3.1–3.6) and 5.3% (3.7–6.0) after 5 and 15 min for STD ( p Conclusion Although polidocanol foam shows greater stability than STD foam perhaps remaining in the vein for longer, endothelial cell loss and damage to the media were significantly greater with STD.