Aims and objectives
Venous malformations (VMs) are the commonest type of vascular malformations,
having different clinical presentations like disfigurement,
pain,
swelling,
etc.
[1] Injection sclerotherapy is an effective treatment modality for slow flow malformations including VMs.
[1-6] Various drugs and methods with varying results exist in the literature.
[1-6] We undertook chart analysis of symptomatic venous malformations (VMs) treated with image guided sclerotherapy using 3% polidocanol (POL) foam at our centre.
Methods and materials
Consecutive cases treated at the interventional radiology service over 4 years period from Sep 2013 to April 2017 were included in the study.
Minimum follow up of any case was six months.
Preoperative clinical data and the follow up findings recorded by the surgeon colleagues (KB,
BK,
SK) were retrieved and charted,
and the images reviewed by the radiologists (SK,
PK).
All interventions had been done by single operator (SK).
Syndromic malformations were excluded from the review.
Oral cavity and tongue lesions were not included...
Results
There were 27,
36,
14 and 8 type 1,
2,
3 and 4 lesions (US or Puig's type)(n= 85; 49 male,
26 female; mean age 16.5 years); with number of sessions 5.3,
4.3,
4.1 and 4 respectively,
correlating with lesion size (P<0.0001); while POL used was 14.24,
16.1,
23.2 and 16.7 ml respectively.
Complications were local site pain and swelling (n=60),
or chest pain (n=2).
59 patients had undergone only US guided procedure,
fluoroscopy guidance (in addition to US) was used in 16,
and in...
Conclusion
Image guided sclerotherapy with 3% polidocanol foam is highly efficacious treatment venous malformations.
US guidance is appropriate in most cases.
In challenging lesions,
phlebography and digital subtractiont techniques,
with mutliple needle punctures adn utilisation of negative filling technique can be extremely useful.
References
Yamaki T,
Nozaki M,
Sakurai H,
et al.
Prospective randomized efficacy of ultrasound guided foam sclerotherapy compared with ultrasound-guided liquid sclerotherapy in the treatment of symptomatic venous malformations.
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Berenguer B,
Burrows PE,
Zurakowski D,
et al.
Sclerotherapy of craniofacial venous malformations: complications and results.
Plast Reconstr Surg 1999;104:1.
Yakes WF.
Diagnosis and management of low-flow veno-lymphatic vascular malformations.
Ces Radiol 2008; 62: 131
Dubois J.
Percutaneous sclerotherapy: recipe for perfect cooking.
Pediatr Radiol 2011; 41 (Suppl 1):S107–S109 DOI: 10.1007/s00247-011-1982-x
Cabrera Garrido...