sclerosant

A sclerosant is a chemical agent used to deliberately injure the lining of a vessel, duct, or cavity in order to provoke inflammation, thrombosis, and fibrosis that obliterates the treated lumen. Through this mechanism, blood flow, lymphatic drainage, or fluid leakage can be reduced or stopped. Sclerosants are employed across several medical specialties, most prominently in procedures to treat abnormal veins and lymphatic malformations, as well as in pleurodesis to prevent recurrent pleural effusions or pneumothorax.

Common sclerosants include ethanol (absolute alcohol), polidocanol, and sodium tetradecyl sulfate, which are widely used for sclerotherapy of varicose veins and venous malformations. Talc, hypertonic saline, and doxycycline are other agents used for cavity- or space-obliterating procedures such as pleurodesis; bleomycin is used in some lymphatic malformations. The choice of agent depends on the lesion type, size, location, and patient factors, with considerations for safety and tolerability.

Administration is typically via targeted injection into the lesion under ultrasound or fluoroscopic guidance, or by instillation into a body cavity. Local anesthesia is common, and operators take care to minimize unintended tissue injury and systemic toxicity.

Adverse effects range from transient pain and swelling to inflammation, pigmentation changes, or tissue necrosis with extravasation. Less common risks include allergic reactions, skin ulcers, and, with systemic exposure, cardiopulmonary or hematologic complications.