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. 2018;1(1):2.
doi: 10.1186/s42155-018-0009-1. Epub 2018 Jun 28.

Image guided sclerotherapy for the treatment of venous malformations

Johnathon Gorman  1 , Steven J Zbarsky  1 , Rebecca J M Courtemanche  2 , Jugpal S Arneja  3 , Manraj K S Heran  4 , Douglas J Courtemanche  3
Affiliations

Image guided sclerotherapy for the treatment of venous malformations

Johnathon Gorman et al. CVIR Endovasc. 2018.

Abstract

Background: Percutaneous sclerotherapy is the preferred method of treatment for VMs (venous malformations). However, treatment protocols vary, and research on the most effective sclerosant is conflicting. Additionally, there is limited knowledge on the effect of sclerosant volume on treatment outcome. This study aims to determine the outcomes and complications of image-guided sclerotherapy for VMs with respect to sclerosant and sclerosant volume. Towards this, a 10-year retrospective chart review was conducted of patients with VMs treated with sclerotherapy at the Vascular Anomalies Clinic at British Columbia Children's Hospital.

Results: Thirty-four patients with VMs were treated of which 15 had a successful outcome, 13 had a failed outcome, and 6 had additional planned treatments after the study time period. Lesions on the head and neck or classified as type I or II had the highest success rates. Combination therapy with both ethanol and 3% STS (sodium tetradecyl sulphate), and ethanol alone had a higher success rate (64% and 60%) compared to 3% STS (11%). Major complications were most associated with 3% STS (17%) followed by ethanol (9%), and no major complications were found with combination. No relationship between the volume of sclerosant per lesion volume and outcome was found.

Conclusions: Combination and ethanol were the most effective sclerosants in terms of highest success rates and lowest complication rates, and sclerosant volume per lesion volume had no effect on outcomes. Future work should aim at studying larger sample sizes to account for the multiple factors that may influence the choice of sclerosant and treatment outcomes.

Keywords: Sclerotherapy; Vascular anomalies; Vascular malformations; Venous malformations.

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Conflict of interest statement

JA, MH, and DC are members of the vascular anomalies clinic at BC Children’s Hospital, which cares for pediatric and adult patients. JA and DC are plastic surgeons and MH is an interventional radiologist. The vascular anomalies clinic team is also composed of a specialist nurse, an otolaryngologist, medical genetics, pediatrics, dermatology, orthopedics, occupational therapy.This study is not a randomized control trial so it isn’t registered. It is a retrospective study with research ethics board approval. This study was approved by, and a waiver of consent was obtained from the University of British Columbia Children’s and Women’s Research Ethics Board, H13–01399.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Success and failures of treatment for each class of VM
Fig. 2
Fig. 2
Major and minor complication rate for each sclerosant. Single treatment with bleomycin excluded
Fig. 3
Fig. 3
Success rate versus complication rate for each sclerosant. Size of dot corresponds to the number of times agent was used. Single treatment with bleomycin excluded
See this image and copyright information in PMC

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