Foam sclerotherapy of venous malformations

Venous malformations may occur either as localized or segmental lesions. Radiologic imaging defines the extent of involvement but magnetic resonance imaging is the best modality: it gives a bright hypersignal on T2-weighted spin-echo sequences. During a 30-month period, 1427 patients were investigated for venous disorders and 1% were found to have venous angiomata (9 women and 5 men). The age range was 15 to 76 years (mean 30.8+/-18.6 years). Foam was produced by the Tessari technique using 1% or 2% concentration of polidocanol. The duplex Doppler was used for ultrasound guidance to insure intravenous flow of foam and to monitor effects of treatment. A goal of pain-free healing of ulcers or cosmetic improvement was set for each patient. The mean number of treatments was 3.6+/-2.8 (range 1-10). Pain-free healing was achieved in patients with non-healing ulcerations and cosmetically, all of the patients were improved. Sclerosant foam is useful in treating low-flow venous malformations.