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Updated: Mar 15, 2026
A Patient-Derived Xenograft Model for Venous Malformation
Published on: June 15, 2020
Management of pediatric intramuscular venous malformations
Minna M Wieck1, Donna Nowicki1, Kathy A Schall1
1Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Background:
Intramuscular venous malformations (VMs) are rare, but can be highly symptomatic. There are few reports on outcomes, particularly pain, functional limitations, and muscle contractures. We aimed to compare results of medical management, sclerotherapy, and surgical resection.
Methods:
We retrospectively reviewed 45 patients with an extremity or truncal intramuscular VM between June 2005 and June 2015 at a single institution. Outcomes were compared between treatment modalities with ANOVA and χ2 tests.
Results:
Six patients (13%) were treated with medical management, 4 (9%) with surgical resection, 23 (51%) with sclerotherapy, and 12 (27%) with both surgery and sclerotherapy. Sclerotherapy alone decreased pain in 72%. Only 20% of patients presented with muscle contracture. For these patients, 33% resolved with sclerotherapy, physical therapy, and aspirin; 22% resolved with surgery, and 45% had persistent contracture. 40% of patients treated with sclerotherapy then surgery developed new muscle contractures, compared to 4% of sclerotherapy only patients and 0% of surgery only patients (p=0.04).
Conclusions:
Medical management, surgery and sclerotherapy are effective treatments for intramuscular VMs. Observation and supportive care can be a primary treatment for patients with minimal symptomatology and no functional limitations. Sclerotherapy is more effective for treating pain than contractures and when used alone, rarely causes a new muscle contracture.
Insights
Sclerotherapy effectively reduces pain from intramuscular venous malformations (VMs) but is less effective for contractures. Surgery alone rarely causes new contractures, unlike combined treatments.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Dermatology
Background:
- Intramuscular venous malformations (VMs) are rare but can cause significant symptoms.
- Limited data exists on treatment outcomes, especially regarding pain, function, and contractures.
Purpose of the Study:
- To compare the outcomes of medical management, sclerotherapy, and surgical resection for intramuscular VMs.
- To evaluate treatment effectiveness for pain, functional limitations, and muscle contractures.
Main Methods:
- Retrospective review of 45 patients with extremity or truncal intramuscular VMs (June 2005-June 2015).
- Comparison of outcomes between treatment modalities using ANOVA and chi-squared tests.
Main Results:
- Sclerotherapy alone improved pain in 72% of patients.
- Muscle contractures resolved in 33% with conservative management and 22% with surgery; 45% persisted.
- New contractures developed in 40% of patients treated with sclerotherapy followed by surgery, versus 4% with sclerotherapy alone and 0% with surgery alone (p=0.04).
Conclusions:
- Medical management, sclerotherapy, and surgery are all effective for intramuscular VMs.
- Observation and supportive care are suitable for minimally symptomatic patients.
- Sclerotherapy is more effective for pain than contractures and rarely causes new contractures when used alone.
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