Results of interventional treatment of peripheral slow-flow malformations

Abstract

Background: In recent years sclerotherapy has increasingly become the treatment of choice for peripheral slow-flow malformations. However, the long-term effectiveness of sclerotherapy is still a matter of debate, especially when it comes to new sclerosing agents like polidocanol. This study aims at gathering further information concerning its long-term effectiveness and safety.

Results: Most patients reported a reduction of symptoms which include pain (57,7%), swelling (65,4%) and functional impairment (60%). Cosmetic complaints were less likely to be reduced by sclerotherapy (44,4%). In most cases a relief of symptoms was stable for many years, especially after several consecutive treatment sessions. Complication rates were comparably low, with only 2 patients requiring additional treatment at hospital and no lasting damages. (…) (7) Most patients (70,9%) were at least partially satisfied with the treatment. Satisfaction was closely linked to a partial or complete relief of symptoms (p = 0.001).

Conclusion: Sclerotherapy is a promising way of treating slow-flow-malformations. Polidocanol has proved to be a save sclerosing agent. The reduction of major symptoms was substantial in most cases and lasted for many years.

Keywords: Embolization; Intervention; Peripheral malformations; Slow flow.

Fig. 1

Aspect of a superficial VM on the left foot

Fig. 2

US imaging of a VM on the right lower leg in a 20-year-old patient

Fig. 3

Imaging of a VM on the forehead of a 55-year-old patient using CT

Fig. 4

Imaging of an extensive VM on the right thigh in a 24-year-old patient

Fig. 5

Slow filling of a VM of the right elbow after contrast medium injection

Fig. 6

Aspect of a well-defined (top) and diffuse (bottom) VM on MRI

Fig. 7

Patient with a VM in the neck area. Above: Phlebographic findings before the intervention. Bottom: MRI findings before the intervention (left) and after (right)