Sodium tetradecyl sulfate
Sources réglementaires consultées
Indications approuvées
- Traitement des petites varices non compliquées des membres inférieurs présentant une dilatation simple avec des valvules compétentes, après évaluation du rapport bénéfice-risque.
Contre-indications
Absolues
- Hypersensibilité antérieure au tétradécylsulfate de sodium ou état allergique.
- Thrombophlébite superficielle aiguë, incompétence valvulaire ou veineuse profonde, phlébite migratrice, cellulite aiguë ou infection aiguë.
- Grosses veines superficielles largement communicantes avec les veines profondes, varices dues à des tumeurs abdominopelviennes non retirées ou alitement.
- Maladies systémiques non contrôlées, notamment diabète, hyperthyroïdie toxique, tuberculose, asthme, néoplasie, sepsis, dyscrasies sanguines et maladies respiratoires ou cutanées aiguës.
Mises en garde cliniques
- Mise en garde majeure · Administrer uniquement par du personnel expérimenté en anatomie veineuse et en sclérothérapie, avec un équipement de réanimation disponible. Une anaphylaxie mortelle peut survenir : injecter d'abord 0,5 ml dans une varice et surveiller pendant plusieurs heures avant d'administrer une dose ultérieure ou plus importante. — https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=997394e1-ec1f-4093-e053-2a95a90a0ea0
- Mise en garde majeure · Une extravasation peut provoquer une nécrose ; vérifier soigneusement la position intraveineuse et utiliser le plus petit volume efficace. Évaluer la compétence valvulaire et la perméabilité veineuse profonde avant l'injection. — https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=997394e1-ec1f-4093-e053-2a95a90a0ea0
- Mise en garde majeure · Des thromboses veineuses profondes et des embolies pulmonaires ont été rapportées jusqu'à quatre semaines plus tard ; assurer un suivi suffisant et une compression appropriée après le traitement. — https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=997394e1-ec1f-4093-e053-2a95a90a0ea0
- Mise en garde majeure · Éviter la mousse préparée avec de l'air ambiant : sa sécurité et son efficacité ne sont pas établies et des embolies artérielles, accidents vasculaires cérébraux, accidents ischémiques transitoires, infarctus du myocarde et altérations de la fonction cardiaque ont été rapportés. — https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=997394e1-ec1f-4093-e053-2a95a90a0ea0
- Une douleur, une urticaire ou une ulcération au site d'injection ont été rapportées à une fréquence non établie ; une coloration permanente peut persister le long du segment veineux sclérosé. — https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=997394e1-ec1f-4093-e053-2a95a90a0ea0
- Mise en garde majeure · Utiliser avec une prudence particulière en cas de maladie artérielle sous-jacente, notamment d'athérosclérose périphérique marquée ou de thromboangéite oblitérante (maladie de Buerger). — https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=997394e1-ec1f-4093-e053-2a95a90a0ea0
Interactions médicamenteuses
- ModéréeHéparine dans la même seringue
Mécanisme: Le tétradécylsulfate de sodium et l'héparine sont incompatibles dans la même seringue.
Recommandation: Ne pas mélanger dans la même seringue.
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=997394e1-ec1f-4093-e053-2a95a90a0ea0
- ModéréeContraceptifs hormonaux
Mécanisme: Il n'existe pas d'études bien contrôlées et des facteurs de risque thrombotique peuvent coexister.
Recommandation: Évaluer individuellement avant de commencer la sclérothérapie.
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=997394e1-ec1f-4093-e053-2a95a90a0ea0
Effets indésirables
Rares mais graves
Anaphylaxie ou choc anaphylactique, y compris des cas mortels · Thrombose veineuse profonde ou embolie pulmonaire · Nécrose tissulaire après extravasation · Accident vasculaire cérébral ou infarctus du myocarde
Grossesse et allaitement
Pendant la grossesse, administrer uniquement si cela est clairement nécessaire et si le bénéfice l'emporte sur le risque. On ignore si le produit est excrété dans le lait maternel ; utiliser avec prudence pendant l'allaitement.
Bibliographie récente (PubMed)
Venous malformation (VM) stands as the most prevalent form of vascular malformation, characterized by its diverse morphology. These lesions can manifest in any part of the body, affecting different tissue planes and giving rise to symptoms such as pain, swelling, or physical dysfunction. In the realm of treatment, direct puncture VM sclerotherapy holds its place as the primary approach. This technique involves the administration of a sclerosing agent into the VM channels during contrast phlebography while simultaneously managing the outflow veins through different methods. The process of VM sclerotherapy induces endothelial damage, thrombosis, and fibrosis, resulting in symptom relief through lesion shrinkage. It is crucial to exercise caution techniques and sclerosing agents during VM sclerotherapy to minimize procedural complications, enhance clinical outcomes, and ultimately improve the patient's overall quality of life.
Overgrowth syndromes, particularly within the PIK3CA-related overgrowth syndrome (PROS) spectrum, are commonly associated with venous anomalies. The anomalies include spongiform venous malformations and persistent embryonic veins, such as the lateral marginal vein (of Servelle). The anomalous veins pose a significant risk of thromboembolic disease and should be occluded, preferably earlier in life. A thorough understanding of the conditions, anatomy, and interdisciplinary treatment of these complex anomalies is essential for optimal management. This review explores the clinical and imaging diagnosis of overgrowth syndromes and techniques for assessing and treating associated venous anomalies, particularly the endovenous closure of anomalous veins.
Sclerotherapy for venous malformation has been widely used; however, no guidelines are available to assess the effectiveness of different sclerotherapy agents. We conducted a systematic review and network meta-analysis to investigate the effectiveness of sclerotherapy agents for venous malformations. Three electronic databases were searched from their inception (1950) to April 29, 2021. Studies comparing the effectiveness of different sclerotherapy agents were included. The risk of bias within and across studies was assessed. Pairwise meta-analyses were conducted, followed by a network meta-analysis. We also assessed inconsistency and publishing bias using various approaches. Seven studies with 547 patients in six arms were included in the present study. We defined the response and complete response as two separate outcomes. Significant differences were observed in four comparisons with respect to the response (ethanol vs bleomycin, ethanol vs polidocanol, ethanol vs sodium tetradecyl sulfate, polidocanol vs sodium tetradecyl sulfate). No statistically significant differences were found in the other comparisons. The evidence network revealed that for the response outcome, ethanol ranked first, followed by pingyangmycin, polidocanol, sodium morrhuate, bleomycin, and, finally, sodium tetradecyl sulfate. For the complete response outcome, pingyangmycin had the best results, followed by sodium morrhuate, polidocanol, ethanol, bleomycin, and, finally, sodium tetradecyl sulfate. Major complications, such as facial nerve palsy, serious local swelling, and necrosis, had occurred mostly in the ethanol group and rarely in the other groups. Because of the limited data, no further analysis of major complications was conducted. Our confidence in the comparisons and rankings was low. We found no verified inconsistency or publishing bias in the present study using the existing approaches. Ethanol showed a significantly better response statistically compared with the other agents.
Hereditary hemorrhagic telangiectasia (HHT) is a common inherited condition characterized by mucosal telangiectasias, recurrent epistaxis, and arteriovenous malformations. HHT results in detriment to quality of life. Morbidity and mortality result from severe anemia. Conventional interventions for HHT-related epistaxis include nasal packing, diathermy, lasers, coblation, microdebridement, bevacizumab (topical and systemic), as well as septodermoplasty and nasal closure. Sclerotherapy has been recently described in the literature as a novel approach to HHT-related epistaxis. We hypothesize that sclerotherapy is an effective treatment for HHT-related epistaxis and improves upon the current standard of care for this disease. A systematic review was conducted to study sclerotherapy for treating HHT-related epistaxis. Ovid MEDLINE, Ovid EMBASE, Scopus, and Web of Science were searched. Articles were evaluated and excluded according to PRISMA guidelines and reviewed by 2 authors. Reported variables included number of injections, months of follow up, changes in Epistaxis Severity Score, previous treatments used to control epistaxis, and post-injection side effects. Seven studies with a total of 196 patients met inclusion criteria. Three studies reported significant improvement as measured by the Epistaxis Severity Score scale. One reported improvement through subjective patient surveys and others used the Bergler-Sadick scale to measure frequency and intensity of epistaxis. All studies reported improvement in HHT-related epistaxis. The lack of uniform reporting measures however precluded formal meta-analysis. Based on limited data, sclerotherapy appears to be effective for treating HHT-related epistaxis and offers promise for treating this recalcitrant condition. However, larger, prospective, multi-centered studies using universally validated instruments for epistaxis are needed to definitively evaluate outcomes from sclerotherapy.