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The Tessari Method by Dr. Peter Bream

The Tessari Method is the standard method for creating foam from liquid sclerosants. Foam sclerotherapy is a minimally invasive technique to close blood vessels in varicose veins and restore the blood flow in healthy veins, with or without ultrasound guidance. In this video, Interventional Radiologist Dr. Peter Bream explains the Tessari Method (3-2-1 Foam Sclerosant Creation).

This video was uploaded to YouTube by Peter Bream.

What is a Foam Sclerosant?

A foam sclerosant is used in treating varicose veins, it is created by mixing air with a sclerosing agent, such as STS. Foam sclerosants are very useful for treating larger veins and can be tracked via ultrasound. They are less diluted when injected into a vein, so the sclerosant will come in contact with the entire wall of the vein.

Creating the Foam with the Tessari Method

Preparation of the foam sclerosant using the Tessari Method is quick and easy: you will need 10 mL Lipiodol, 20mL of 3% Sodium Tetradecyl Sulfate, and 30mL of room air to create 60-75mL of foam. Other material include 3 3mL polycarbonate syringes, 1 10mL polycarbonate syringe, 2 20mL polycarbonate syringe, 3 polycarbonate three-way stopcocks, 2 60mL syringes, a filter needle, and a hemostat.

1. Begin by adding 20mL of 3% Sodium Tetradecyl Sulfate into the 60 mL syringe.
2. Using a filter needle, draw up 10mL of Lipiodol into a 20mL polycarbonate syringe. Use the hemostat to remove the filter needle.
3. Connect the two syringes with a stopcock and inject the Lipiodol into the Sodium Tetradecyl Sulfate.
4. Using both 60mL syringes and stopcock, agitate the mixture of air, Sodium Tetradecyl Sulfate, and Lipiodol. This mixture will expand to give more than 60mL of foam.
5. Attach the 20mL polycarbonate syringe and transfer the foam.
6. Attach a 3mL polycarbonate syringe to the stopcock to draw up a portion for treatment.

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