Mechanism of thrombosis caused by sclerotherapy of esophageal varices using sodium tetradecyl sulphate

The mechanism of thrombosis following intravariceal injection of sodium tetradecyl sulphate (S.T.D.) was investigated with respect to effects on the vascular endothelium, the coagulation cascade, and platelet function. Using an umbilical cord model designed to simulate blood flow over the endotheliu...

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Bibliographic Details
Published in:	Surgical endoscopy Vol. 6; no. 1; pp. 4 - 9
Main Authors:	JACOBSON, B. F, FRANZ, R. C, HURLY, E. M, NORMAN, G. L, BECKER, P, MYBURGH, J. A, MENDELOW, B. V
Format:	Journal Article
Language:	English
Published:	New York, NY Springer 1992
Subjects:	Biological and medical sciences Blood Coagulation - drug effects Blood Platelets - drug effects Digestive system Endothelium, Vascular - drug effects Esophageal and Gastric Varices - therapy Humans Medical sciences Microscopy, Electron, Scanning Pharmacology. Drug treatments Platelet Aggregation - drug effects Sclerosing Solutions - therapeutic use Sodium Tetradecyl Sulfate - therapeutic use Umbilical Veins - drug effects Pathology Treatment Coagulation Esophageal disease Digestive diseases In vitro Endothelium Varix
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Summary:	The mechanism of thrombosis following intravariceal injection of sodium tetradecyl sulphate (S.T.D.) was investigated with respect to effects on the vascular endothelium, the coagulation cascade, and platelet function. Using an umbilical cord model designed to simulate blood flow over the endothelium, it was found that S.T.D. is a potent toxin for endothelial cells in that brief exposure to even low concentrations of the agent were effective in stripping endothelium over a considerable distance, exposing highly thrombogenic endothelium in the process. Effects on coagulation and platelet function were found to be dependent on concentration. Diluted S.T.D. induced a hypercoagulable state, possibly in consequence of a selective inhibition of the physiological anticoagulant, protein C, and promoted platelet aggregation. Higher concentrations inactivated the coagulation cascade and lysed platelets completely. These results suggest that intravariceal infusion of S.T.D. at considerable dilution may be at least as effective in inducing thrombosis as standard dosage, and possibly more so.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0930-2794 1432-2218
DOI:	10.1007/BF00591179