| Objective: The physical properties of home-made foam sclerosing agents made from polydocanol in combination with pingyangmycin and the effect of their home-made sclerosing agents on rabbit ear marginal veins were investigated to provide a theoretical basis for exploring the value of their combined treatment in the context of human venous malformations.Methods: Different concentrations of Pingyangmycin(PYM)(0%,0.01%,0.05%,0.1%,0.2%,0.3%)and different concentrations of polydocanol(POL)(1% and 3%)were combined with each other and made into a foam hardener using the Tessari method at a constant 25°C,i.e.using a 3-way valve.A 5m L syringe was connected to the syringe and the foam was rapidly and repeatedly injected at a 4:1 gas-liquid ratio.The physical properties of the groups were compared and the one with the most stable physical properties was selected for the animal experiments.Groups A,B,C and D were taken at 1d,3d,7d,14 d and 21 d for HE staining and Western Blot,respectively.The experimental and control groups were compared and statistically analyzed.Results:(1)Foam diameter: In the in vitro experiments,the foam diameters of different concentrations of pingyangmycin combined with 1%polydocanol were larger than those of 1% polydocanol alone,and there were some statistical differences(p < 0.05);the foam diameters of different concentrations of pingyangmycin combined with 3% polydocanol were larger than those of 3% polydocanol alone,and there were some statistical differences(p < 0.05).(2)Foam wall thickness: in animal experiments,the use of 1% and 3%concentrations of polydocanol alone compared with 1% and 3% concentrations of polydocanol and different concentrations of homemade foams of pingyangmycin in terms of foam wall thickness and was statistically different(p < 0.05)(3)Drainage time(i.e.the time required for the foam to start turning into a liquid): in in vitro experiments,the drainage times of homemade foams with1% and 3% polydocanol alone versus 1% and 3% polydocanol and different concentrations of pingyangmycin were greater than those of the control,and were statistically different(p < 0.05);homemade foams with 3% polydocanol and pingyangmycin The time to precipitation was greater for both 3%polydocanol and pingyangmycin than for 1% polydocanol and pingyangmycin,(p<0.05)(4)Half-life(i.e.the time required for the home-made foam to become liquefied to half its volume): in in vitro experiments,the half-life of home-made foams with 1% and 3% concentrations of polydocanol alone compared with 1%and 3% concentrations of polydocanol and different concentrations of pingyangmycin was generally greater than that of the control group and was statistically different(p < 0.05);the half-life of 3% polydocanol with pingyangmycin The half-life of the home-made foam of 3% polydocanol and pingyangmycin was greater than that of 1% polydocanol and pingyangmycin(p<0.05)(5)In animal experiments,there was a statistically significant difference in the rate of lumen occlusion at 1d,3d,7d,14 d and 21 d postoperatively between group A and group D(p<0.05);there was a statistically significant difference in the rate of lumen occlusion at 1d,3d,7d,14 d and 21 d postoperatively between group B and group D(p<0.05);group C compared with group D at 1d,3d,7d,14 d and 21 d postoperatively There was a statistically significant difference in the rate of lumen occlusion between group C and group D at 1d,3d,7d,14 d and 21d(p<0.05).(6)From the 3rd postoperative day,and the difference has a significant statistic in the rate of lumen occlusion in group C compared to groups A,B and D(p<0.05).(7)There were no statistically significant differences in the lumen occlusion rate between group A and group B at 7d,14 d and 21 d postoperatively(p>0.05).(8)Group C was almost completely occluded from the 3rd postoperative day compared to groups A,B and D(p<0.05)(9)The combination of 3% polydocanol and 0.1% Pingyangmycin(4mg/m L)homemade foam sclerosing agent is simple to perform,has few adverse effects and has a high rate of one-stage closure in the treatment of human venous malformations.Conclusion:(1)The foam stability(foam diameter,foam wall thickness,precipitation time,half-life)of the home-made foam sclerosing agent with polydocanol and pingyangmycin was more stable than with polydocanol alone,and the combination of 3% polydocanol and pingyangmycin was more stable(especially the combination of 3% polydocanol and 0.1% pingyangmycin)(2)The 3% polydocanol and 0.1% Pingyangmycin homemade foam sclerosing agent was superior to either polydocanol or Pingyangmycin alone in animal studies(both in terms of time taken for vessel occlusion and rate of vessel occlusion)and was ultimately used to treat venous malformations by aggravating endothelial cell swelling and hyperplasia leading to lumen occlusion.(3)The combination of 3% polydocanol and 0.1% pingyangmycin in a homemade foam sclerosing agent is clinically effective in the treatment of human venous malformations with fewer adverse effects and less toxic effects,and as more patients are treated and evaluated at follow-up,this sclerosing method offers more options for the clinical treatment of venous malformations. |
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