DIFFERENCES IN HEMOSTASIS AMONG SCLEROSING AGENTS IN ENDOSCOPIC INJECTION SCLEROTHERAPY

Endoscopic injection sclerotherapy is useful in stopping bleeding from esophageal varices, We compared the in vivo effects of sclerosants on thrombogenesis, hemostasis, and endothelial injury, We injected aetho xysclerol (AS) or ethanolamine oleate (EO) into the small veins of the rat intestine, The maximum thrombogenic index with AS was 30.7 and wi th EO was 9.2, The venous flow stopped sooner with EO than with AS, Th e thrombi caused by EO were mixed with red blood cells, Heparin pretre atment decreased the thrombogenic index with AS by 96.7%, but not that with EO. The area of the fluorescein-albumin conjugate that permeated from veins with AS was larger than that with EO, The fluorescent inte nsity with AS was lower than that with EO, We thus concluded that: (1) the size of thrombi is not necessarily proportional to the hemostatic efficacy: (2) changes in a patient's coagulation may affect the poten tial of sclerosants: (3) the excellent hemostatic efficacy of EO is ba sed on localized injury to the endothelium and the involvement of red blood cells aggregation; and(4) in vivo microscopy is useful in determ ining the rational selection of sclerosants.