espuma esclerosante varices

VARIXIO represents
a new generation
in sclerotherapy.

VARIXIO is the most advanced sclerosant foam preparation system for the treatment of varicose veins of any size as it allows the preparation of foam even at very low sclerosant concentrations.

WHY USE VARIXIO?

Three reasons motivated the development of a new foam preparation system: the need for STANDARDISATION, VERSATILITY and IMPROVED SAFETY.

Standardisation

VARIXIO offers an automated, standardised system. High quality foam always.
Currently, foam is generally produced using manual methods with different materials. Manual agitation is not usually standardised.

Greater versatility

VARIXIO allows the production of stable foam even at concentrations of POL and STS.
Foam has been demonstrated to be superior to liquid for the treatment of large veins. In spider veins, foam has not demonstrated superiority to liquid injection, probably because it has not been possible to prepare foams at low sclerosant concentrations.

Improved safety

VARIXIO Pod Air allows the preparation of foam at very low concentrations of sclerosant, avoiding the risk of overdose. VARIXIO Pod O2CO2 (currently in development) will provide a preparation system for up to 15 mL of foam made from physiological gas.
Some conditions, such as certain venous malformations and large varicose veins, require injection of large volumes of foam. Patients with patent foramen ovale are at higher risk of adverse events from the passage of air to the arterial system.

VARIXIO Pod Air

The start
of a revolution

In 2013, in Clínica Vascular Barcelona, Dr Enric Roche and Dr Antoni Puig began working with a prototype consisting of a sterile sample pot with a customised laboratory magnet inside it (JP Selecta). When the sclerosing agent was added and the stirring system set at a high number of revolutions, it produced a high-quality foam.

At the 2014 European Venous Forum in Paris, Dr Roche presented the results of a comparative study of the foam created with this new method against that created with the traditional method (Tessari method). The conclusions were that this new system was effectve preparing foam made from air or physiological gases. In comparison with the manual method (Tessari) they were more homogeneous, more stable, and moreover could be prepared even from very low concentrations of sclerosing agent.

About VB Devices

VARIXIO foam

The aim of VARIXIO is to provide the operator with a product that facilitates the automated preparation of a standardised, high-quality foam, with maximum versatility.

The VARIXIO system allows the preparation of foam using:

  • Sterile air (VARIXIO Pod Air) or O2CO2 (VARIXIO Pod O2CO2)
  • Polidocanol or sodium tetradecyl sulfate (STS) at concentrations from 0.2%.

The VARIXIO system consistently produces sclerosant foam with the following characteristics:

  • Bubble diameter less than 250 µm (from 84±14 to 119±6. Average 100 µm)
  • Mean half-life of up to 5.2 minutes.
  • Gas:liquid ratio of between 4:1 and 7:1.

The quality and consistency of the microfoam can be appreciated in the following images. Individual photos show the foam after passage through different needle gauges.

The results of the studies performed in the development phase allowed us to define specific stirring programmes – according to the choice of sclerosant (polidocanol or STS), the concentration used, and the type of gas (air or physiological gas mix) – that would optimise the quality of the resulting foam.

The VARIXIO Pro Mag has a simple menu that allows the user to select the appropriate parameters for each case.

For more information please see the published article:

Roche E., Pons R., Roche O., Puig A., A new automated system for the preparation of sclerosing foam: A study of the physical characteristics produced and the device settings required. Phlebology 0(0) 1-10.2020.)

Microfoam for varicose veins and spider veins
tratamiento varices
0.18% POL microfoam.
tratamiento varices
Dispersion of the 0.18% POL microfoam.

Practical tips

VARIXIO should only be used by doctors or health care professionals with experience in varicose vein sclerotherapy treatment protocols. The procedure should be performed following the general principles of asepsis and handling that are usually applied in sclerotherapy and it’s important to review the data sheet of the sclerosing agents that will be used, because at certain concentrations it is not possible to produce foam with manual systems.

VARIXIO should be used according to the steps described below:

Download Manual
SYRINGES:
  • We recommend 5 or 10 mL 2-piece silicone-free syringes.
  • BD and Terumo syringes perform better than other brands.
  • The 3-piece syringe that performs the worst is the B.Braun Omnifix. The plunger destroys the foam’s structure immediately, especially if STS is used. Its use is therefore contraindicated.
  • If using a 2-piece syringe, it is recommended to add a particle filter such as the 5-micron Sterifix Pury (B.Braun) to the Luer tip. This filter allows a smoother pressure on the plunger and homogenises the foam even more.
  • 5 mL syringes offer greater foam stability than 10 mL syringes but, depending on the treatment volumes, it is recommended to only aspirate the foam once.
FILTERS:
  • The use of particle filters such as the 5-micron Sterifix Pury (B.Braun) exert a homogenising effect that is particularly useful when using a 2-piece syringe as it minimises friction between the syringe piston and shaft.
EXTENSIONS SETS:
  • VARIXIO foam allows connection of 23G, 25G, and 27G butterfly extension sets without premature destruction of the foam.

 

VARIXIO allows for the preparation of foam even in low concentrations.
The professional must review the data sheet of the sclerosing product, which in some concentrations recommends sclerotherapy in liquid form.

In case of diluting the sclerosing agent:

  • Normal saline is recommended as the diluent. Normal saline does not interfere with or affect the sclerosing agent and its injection is painless and safe, as it has no harmful effects when injected intravenously.
  • Distilled water is painful to inject, especially in small or spider veins. Its copious use may cause haemolysis, it is more irritant, and it generates a greater inflammatory reaction.
  • Glycerin as a nonsclerosing detergent, can be used along with normal saline to potentiate foam stability.
  • Chromated glycerin is a sclerosing agent, not a detergent, and therefore does not generate foam.
  • Storing the sclerosant liquid in a refrigerator favours stability of the resulting foam.