Paediatric sclerotherapy of vascular anomalies of the hand and digits

Vascular anomalies in the hands and digits can cause pain, swelling and restrict the range of motion. Additionally, the small compartments they reside within portend challenges and possible risks in treatment. This study aims to evaluate the safety and efficacy of percutaneous sclerotherapy to treat vascular malformations in the hand and digits in paediatric patients.

Metrics including size and location characteristics of the anomaly, procedural specifics, technical success, clinical success, and adverse events were recorded and further analysed.

Eight paediatric patients (5 males, 3 females) aged 5-17 years (mean 12 years) with vascular anomalies of the hands and digits treated with sclerotherapy were included. Three patients had arteriovenous malformation (AVMs), two venous malformation (VMs), and three venolymphatic malformation (VLMs) based upon imaging. Presenting symptoms included localised pain (n=8), swelling (n=7), decreased range of motion and function (n=3) and distal upper extremity numbness (n=1). Technical success was achieved in all (100%) patients. Seven of the eight patients (87.5%) followed up at six weeks and all reported at least partial reduction of symptoms (100%). Follow-up imaging was available for three patients with all showing decrease in the size of the malformation. There were no intraoperative complications or major adverse events. Three patients (37.5%) reported Society of Interventional Radiology (SIR) grade A/B minor adverse events (swelling [n=3], transient pain [n=3], and poor capillary refill [n=1]). Two patients (25%) benefited with a steroid prescription that successfully abated their symptoms.

Sclerotherapy appears to be a safe and effective treatment for vascular malformations in the hand and digits in paediatric patients.