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Sclerotherapy for venous malformations

A A de Lorimier1

  • 1Department of Surgery, University of California, San Francisco 94143, USA.

Journal of Pediatric Surgery
|February 1, 1995
PubMed
Summary
This summary is machine-generated.

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Sclerotherapy effectively treats extensive venous malformations, even in complex cases like Klippel-Trenaunay Syndrome. This method offers a viable treatment option when surgery is not feasible, leading to high patient satisfaction.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Dermatology

Background:

  • Venous malformations are congenital vascular abnormalities often overlooked in treatment discussions.
  • Sclerotherapy presents a less invasive alternative for extensive venous malformations unsuitable for surgical excision.

Purpose of the Study:

  • To evaluate the efficacy and safety of sclerotherapy for treating 34 cases of venous malformations over 30 years.
  • To highlight sclerotherapy as a primary treatment for extensive venous malformations involving adjacent organ systems.

Main Methods:

  • Utilized sclerotherapy with agents including sodium morrhuate, ethanolamine, sotradecol, and ethyl alcohol.
  • Employed a butterfly needle and three-way stopcock for precise intraluminal injection, with venograms used to assess runoff.

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  • Administered sclerotherapy in single or multiple sessions (up to 30+ injections) depending on lesion size, often requiring general anesthesia.

    • Main Results:

    • Sclerotherapy was successfully applied to diverse venous malformations, including Klippel-Trenaunay Syndrome and head/neck involvement.
    • Treatment volume varied (5-90 mL), with some extensive lesions requiring repeated aggressive treatment due to recanalization.
    • Complications included skin necrosis, nerve palsy, hemoglobinuria, and anaphylaxis, necessitating airway support for pharyngeal/laryngeal cases.

    Conclusions:

    • Sclerotherapy is a tenable and effective treatment for extensive venous malformations where surgical options are limited.
    • Despite potential complications and the need for repeated treatments, patients reported high satisfaction with the sclerotherapy outcomes.