White Rose University Consortium logo
University of Leeds logo University of Sheffield logo York University logo

Optimisation of minimally invasive therapy for primary varicose veins

McAree, Barry Jonathan (2015) Optimisation of minimally invasive therapy for primary varicose veins. M.D. thesis, University of Leeds.

Text (pdf)
BJMCAREE THESIS FOR HARD BACK 2015.pdf - Final eThesis - complete (pdf)
Available under License Creative Commons Attribution-Noncommercial-Share Alike 2.0 UK: England & Wales.

Download (9Mb) | Preview


Introduction: Primary varicose veins are common with a multitude of non-optimal treatments. Foam sclerotherapy has seen renewed interest but lacks efficacy versus more expensive modalities. The hypothesis of this thesis is that increasing the half-life of foams will improve efficacy as will mechanical adjuncts. Methods: The most efficacious proprietary sclerosants are examined in terms of their foam half-life and histopathological effects in-vitro. The best proprietary foam has its half-life increased and histopathological effects of the three most promising resultant foams similarly assessed. Arterial cutting balloons are assessed as an adjunct for foam sclerotherapy in the same in-vitro human GSV model. The best foams are tested against each other and with cutting balloon adjuncts in an animal vein model with results established after three months. Results: half-life of 3% polidocanol foam is longer than 3% STD. 3% STD damages the vein wall more than polidocanol. Longer lasting STD foams do not enhance its activity against vein wall in-vitro. Cutting balloons increase depth of penetration of foam into vein wall by affording it a deeper starting point in-vitro. Cutting balloons damage the structure of the vein wall leaving them varicose in-vivo. This is likely due to available cutting balloons being too large for tested pig veins. Longer lasting 0.15% xanthum and 3% STD foam outperformed proprietary 3% STD in causing vein occlusion in a pig model. Conclusions: The active ingredient in sclerosant foams determine its efficacy in-vitro more so than the longevity of the foam however longer lasting 3% STD foam shows improved efficacy in-vivo in pigs as opposed to in an in-vitro human GSV model. Cutting balloons though promising in-vitro as adjuncts to foam sclerotherapy are likely best used as a guide to a more optimal mechanical adjunct.

Item Type: Thesis (M.D.)
Keywords: Foam sclerotherapy, optimisation
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds)
Identification Number/EthosID: uk.bl.ethos.675024
Depositing User: Mr Barry / BJ McAree
Date Deposited: 09 Dec 2015 10:42
Last Modified: 18 Feb 2020 12:47
URI: http://etheses.whiterose.ac.uk/id/eprint/11245

You do not need to contact us to get a copy of this thesis. Please use the 'Download' link(s) above to get a copy.
You can contact us about this thesis. If you need to make a general enquiry, please see the Contact us page.

Actions (repository staff only: login required)