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Raymond Tournay (1), cha đẻ của xơ hoá Pháp, tiếp tục có giá trị thậm chí một năm mươi năm sau khi sự đọc đầu tiên của mình, và sự tiến bộ gần đây của xơ hoá bọt, đặt những lời này trong một ánh sáng mới. | 16 Advanced Sclerotherapy The Sclerosing Foam Alessandro Frullini Studio Flebologico Incisa Valdarno Florence Italy Video 18 Sclerosing Foam What is important the most is the concentration inside the vein not in the syringe. R. Tournay 1949 INTRODUCTION This famous axiom from Raymond Tournay 1 the French father of sclerotherapy continues to be valid even a fifty years after its first enunciation and the recent advance of foam sclerotherapy puts these words in a new light. With the sclerosing foam SF it is possible for the first time to achieve full control on drug concentration inside the vein and on the time of contact between the sclerosing agent and the endothelium 2 . The idea of using air and drug in combination is quite old Egon Orbach 3 from Berlin later from New Haven U.S.A. in 1944 employed this in his air block technique which used sodium tetradecyl sulphate STS . The method has been extensively used in the following years only in the treatment of telangiectasias because it was found that in larger veins the air present in the upper part of the vessel impeded full contact between STS and the vein inner wall. The idea was to create an air meniscus which could separate blood and the injected bolus. In his early reports Orbach stated that the method improved the rate of success of sclerotherapy by 10 without significant complications if the amount injected was below 3 cc 4 . Subsequently it was determined that the method worked well only in smaller veins and is still in use for the treatment of telangiectasias. In 1993 Juan Cabrera a Spanish vascular surgeon from Granada proposed the use of CO2 mixed with STS or polidocanol POL in order to form a therapeutic foam 2 . This represented a true revolution in the stagnant world of sclerotherapy from the time of Orbach only three major achievements injection-compression technique according to Fegan use of 317 318 Frullini POL as a sclerosing agent by Henschel and echo-guided sclerotherapy 5-7 represented a true .
