A Modiied 3-Way Tap to Enhance the Stability and Uniformity of Sclerosant Foam

• Published in: Annals of vascular surgery Vol. 70; pp. 501 - 505
• Main Authors: Zhang, Hao, Yang, AiJun, Xu, MingPei, Liu, ShaoHua
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.01.2021
• Subjects: Drug Stability; Equipment Design; Half-Life; Materials Testing; Polidocanol - administration & dosage; Polidocanol - chemistry; Sclerosing Solutions - administration & dosage; Sclerosing Solutions - chemistry; Sclerotherapy - instrumentation; Time Factors
• ISSN: 0890-5096; 1615-5947
• DOI: 10.1016/j.avsg.2020.08.116

The Tessari method, mixing air with the sclerosant through a 3-way tap and 2 syringes, is the most widely used method to prepare foam in foam sclerotherapy. Uniform foam with smaller bubbles has great clinical significance for venous insufficiency. We aim to modify the traditional 3-way tap to produce more uniform and stable foam with smaller bubbles. The traditional 3-way tap was modified by inserting a porous film within its channel. Experiment design: the foam was prepared with 2 mL polidocanol plus 8 mL air plus 0.05 mL hyaluronic acid; group 1, foam prepared with 20 quick passes through a traditional 3-way tap; and groups 2–7, foam prepared using the modified 3-way tap, with 10, 12, 14, 16, 18, and 20 quick passes, respectively. The uniformity of the foam was observed under optical microscopy, and the size of bubbles quantified using the Nano measurement software. The stability of the foam was evaluated using the foam half-life time. The foam half-life times of groups 1–7 were 306.4, 257.4, 285.6, 304.4, 318.6, 330.2, 331.3 sec, respectively. The modified tap also produced a more uniform distribution of smaller bubbles (group 7) compared with traditional tap (group 1). Modified 3-way tap enhanced the stability of the sclerosant foam, with a more uniform distribution of smaller bubbles. •The modified 3-way tap increases the stability and uniformity of the foam.•The modified 3-way tap is a viable sclerotherapy option for venous insufficiency.•The modified 3-way tap may reduce the potential risk of gas embolism.