ABSTRACT
Cyanoacrylates can be used to occlude vessels, including embolization of highflow arterio-venous malformations and, for closure of saphenous veins and tributaries. Lignocaine is the most commonly used anaesthetic in venous practice. A true immunologic reaction to a local anesthetic is rare and most reported reactions are vasovagal or psychogenic. Allergic reactions attributed to local anaesthetics can be caused by preservatives in the solution such as methylparaben and metabisulfite included to prevent bacterial growth, or antioxidants added to prevent oxidation of vasopressors in adrenalinecontaining vials. Local anaesthetic systemic toxicity is least with fast-acting and more frequent with longacting agents. Sclerosants can be detergent, osmotic or chemical irritant agents. Detergent sclerosants are surfactants normally used for reducing surface tension. Two detergent drugs, sodium tetradecyl sulphate and polidocanol, are the most commonly-used agents. Sulodex ine is a pro-fibrinolytic agent consisting of 80% low molecular weight heparin and 20% dermatan sulfate.
