The active ingredient of Aethoxysklerol® is lauromacrogol 400 (polidocanol). The sclerosant has a concentration-dependent effect on the endothelium of blood vessels. Lauromacrogol 400 (polidocanol) acts as a detergent, which forms aggregations of molecules in the form of micelles. The micelles then interact with the membrane of the endothelial cells and disrupt the cells by dissolving essential molecules from the membrane surface.
Therefore, when injected intravenously, lauromacrogol 400 (polidocanol) destroys the vessel walls of the affected varicose veins, thus permanently occluding them. As mentioned above, the drug first induces endothelial damage, which causes platelets to aggregate at the site of damage and attach to the venous wall. Then, a dense network of platelets, cellular debris, and fibrin occludes the vessel. At a later stage the obliterated vein is replaced with connective fibrous tissue.
The fibrous cord is gradually decomposed and absorbed by the body – the treated varicose vein is eradicated.
Consequently, as far as the functional result is concerned, sclerotherapy corresponds to surgical removal of a varicose vein.
Following slerotherapy, a gradient compression stocking or bandage is recommended to reduce the risk of thrombosis and to prevent recanalization of the vein.
Sclerotherapy of hemorrhoidal disease involves the injection of a sclerosing agent into the submucosal layer of the protuding hemorrhoidal node or into the surrounding tissue of the arteries which supply it. The sclerosing agent provokes a discrete inflammatory reaction which results in a scarred structural change of submucosal connective tissue, which consequently achieves fixation of the hemorrhoid to the anorrectal wall. In addition, the obliteration of the vascular bed in and near the hemorrhoidal node may lead to shrinkage of the hemorrhoids. This results in rapid disappearance of symptoms after treatment.