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Foam Skleroterapiye Bağlı Nadir Bir Komplikasyon: Akut Böbrek Hasarı

An Unusual Complication of Foam Sclerotherapy: Acute Kidney Injury

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2014.1003.18
Abstract (2. Language): 
Sclerotherapy, in which an irritant solution is administered, is a method used to treat venous failure that results in complete venous destruction due to endothelial reaction and fibrosis. In recent years, foam sclerotherapy, in which a sclerosing agent (aethyl sclerole) and air are mixed until they turn into foam and the resultant mixture is injected into noticeable veins directly and into other veins under ultrasonography in doses depending on the diameters of the varices, has been introduced. The drugs or gases used in foam sclerotherapy can cause local or systemic complications. Foam affects vessel endothelial cells and causes severe spasm in the vessel. It has been reported that endothelin-1 levels are high after foam sclerotherapy compared to the initial levels and that neurological complications vary with the endothelin levels. In this report, we present a case of acute kidney injury due to acute tubular necrosis probably caused by endothelin release following foam sclerotherapy.
Abstract (Original Language): 
Skleroterapi; irritan bir solüsyon aracılığıyla vende oluşan endotelyal reaksiyon ve fibrozisle komplet venöz destrüksiyona neden olarak venöz yetmezliğin tedavisinde kullanılan bir yöntemdir. Son yıllarda gündeme gelen foam skleroterapi yöntemindeyse; sklerozan ajan (aethyl sklerol) ve hava köpük halini alıncaya kadar karıştırılır. Meydana gelen karışım belirgin varislerde direkt, diğerlerinde ise ultrasonografi eşliğinde varislerin çapına göre değişen iğnelerle damara verilir. Foam skleroterapide kullanılan ilaç veya gaza bağlı lokal veya nadiren sistemik komplikasyonlar oluşabilir. Foam, damar endotelyal hücrelere etki ederek damarda yoğun bir spazma neden olmaktadır. Foam skleroterapi sonrası endotelin-1 seviyelerinin başlangıca göre yükseldiği ve gelişen nörolojik komplikasyonların endotelin yüksekliğine bağlı olduğu belirtilmektedir. Biz, foam skleroterapi sonrası endotelin salınımı aracığı ile oluşabileceğini düşündüğümüz “akut tübüler nekroza bağlı akut renal hasar” gelişen bir olguyu sunuyoruz.
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