Investigation Into the Pathophysiology and Treatment of Varicose Veins
Condition: Varicose Veins
MeSH terms: Varicose Veins
Study type: Interventional

Summary: 
      Chemical sclerotherapy is commonly used to treat varicose veins which affect superficial
      veins in the leg. Sclerotherapy is injected directly into veins where it causes damage to the
      vein wall. If sufficient damage occurs, the vein is transformed into a fibrous cord which
      does not re-open. This study will investigate the structural changes caused to the wall of
      veins following injection with sclerotherapy ex vivo. Vein samples will be obtained from the
      Whiteley Clinic in Guildford from patients undergoing phlebectomy operations. These will then
      be injected with sclerotherapy and the extent of damage will be investigated. Samples will
      also be used for laboratory analysis into the pathophysiology of varicose veins.
    

Detailed description: 
      Varicose veins affect up to 40% of the population and are associated with significant
      discomfort, skin damage, and complications including ulceration and perforation. In recent
      years, there has been a move towards minimally invasive treatment, including chemical
      sclerotherapy. Despite their widespread use,the fundamental effects of sclerosants have not
      been fully characterised. Furthermore, their use is associated with significant rates of
      re-canalisation and clinical recurrence. There is therefore significant scope for researching
      the effects of sclerosants on the vein wall and the mechanisms of cell death. Furthermore,
      the pathophysiology of varicose veins has not been fully characterised. It is the aim of this
      study to research a number of themes related to the use of sclerotherapy and the
      pathophysiology of varicose veins in order to provide information which will both further
      scientific knowledge and further develop clinical practice by optimising the use of
      sclerotherapy. This research will be conducted by a PhD student based at the University of
      Surrey, in conjunction with the Whiteley Clinic in Guildford. Veins and blood samples removed
      following varicose vein surgery at the Whiteley Clinic will be provided for laboratory-based
      research at the university. A range of methodologies will be employed to analyse cellular
      responses to sclerosants to determine the precise structural and biochemical changes which
      lead to destruction of the vein and clinical efficacy, and to investigate a number of key
      themes implicated in the pathophysiology of varicose veins.
    

Intervention name(s): Chemical sclerotherapy; 1% Sodium Tetradecyl Sulphate; 3% Sodium Tetradecyl Sulphate; 0.5% Polidocanol; 3% Polidcanol
Intervention type(s): Procedure; Drug; Drug; Drug; Drug
Intervention description(s): Sclerosant will be retained within the vein; 1% Sodium Tetradecyl Sulphate; 3% Sodium Tetradecyl Sulphate; 0.5% Polidocanol; 3% Polidcanol
Intervention MeSH terms: Polidocanol; Sodium Tetradecyl Sulfate
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Basic Science