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CardioVascular and Interventional Radiology

, Volume 42, Issue 12, pp 1695–1701 | Cite as

Venous Malformations Sclerotherapy: Outcomes, Patient Satisfaction and Predictors of Treatment Success

  • Boris Khaitovich
  • Elinor KalderonEmail author
  • Orna Komisar
  • Michal Eifer
  • Daniel Raskin
  • Uri Rimon
Clinical Investigation Venous Interventions
Part of the following topical collections:
  1. Venous Interventions

Abstract

Purpose

To retrospectively evaluate the results of sclerotherapy for venous malformations, with emphasis on patient satisfaction, complications and predictors of positive response to treatment.

Materials and Methods

Three hundred and nine patients were treated with ethanol sclerotherapy for venous malformations in our center between the years 2000 and 2014. All of them were sent a self-assessment questionnaire for evaluation of their satisfaction and treatment complications. In total, 153 patients (mean age 21, range 6 weeks to 67 years) responded to the questionnaire. We analyzed clinical and imaging data from the medical records of these patients.

Results

Sixty-four (42%) patients had venous malformations in the lower extremities, 35 (23%) in head and neck regions, 33 (22%) in the trunk, 14 (9%) in the upper extremities and 5 (3%) in the buttock and genitalia. Complete relief of swelling, pain, functional and esthetic complaints was reported in 23%, 22%, 17% and 12% of patients, respectively. Thirty-eight (25%) patients reported being very satisfied with treatment outcomes, 55 (36%) were satisfied, 49 (32%) were not satisfied and 11 (7%) were very unsatisfied. We did not find significant correlations between patient satisfaction and demographics characteristics, lesion location, lesion size, tissue involvement or total sclerosant quantity. The rate of class 3 complications was 7% and that of class 4 complications was 2%.

Conclusion

Ethanol sclerotherapy is an effective treatment for venous malformations. Nonetheless, this treatment has a significant complication rate. Patient satisfaction is independent of lesion characteristics and is not as high as may be expected.

Keywords

Sclerotherapy Venous malformation Patient satisfaction 

Notes

Funding

This study was not supported by any funding.

Compliance with Ethical Standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

For this type of study formal consent is not required, as individual patients indirectly consent to participate in the study when completing the questionnaire.

Supplementary material

References

  1. 1.
    Legiehn GM, Heran MKS. A step-by-step practical approach to imaging diagnosis and interventional radiologic therapy in vascular malformations. Semin Interv Radiol. 2010;27(2):209–31.CrossRefGoogle Scholar
  2. 2.
    Carqueja IM, Sousa J, Mansilha A. Vascular malformations: classification, diagnosis and treatment. Int Angiol. 2018;37(2):127–42.PubMedGoogle Scholar
  3. 3.
    Legiehn GM, Heran MKS. Venous malformations: classification, development, diagnosis, and interventional radiologic management. Radiol Clin N Am. 2008;46(3):545–97.PubMedCrossRefGoogle Scholar
  4. 4.
    Muller-Wille R, Wildgruber M, Sadick M, Wohlgemuth WA. Vascular anomalies (part II): interventional therapy of peripheral vascular malformations. Rofo. 2018.  https://doi.org/10.1055/s-0044-101266.PubMedCrossRefGoogle Scholar
  5. 5.
    Green D. Mechanism of action of sclerotherapy. Semin Dermatol. 1993;12(2):88–97.PubMedGoogle Scholar
  6. 6.
    Qiu Y, Chen H, Lin X, Hu X, Jin Y, Ma G. Outcomes and complications of sclerotherapy for venous malformations. Vasc Endovasc Surg. 2013;47(6):454–61.CrossRefGoogle Scholar
  7. 7.
    Horbach SER, Lokhorst MM, Saeed P, de Gouyon Matignon de Pontouraude CMF, Rothova A, van der Horst CMAM. Sclerotherapy for low-flow vascular malformations of the head and neck: a systematic review of sclerosing agents. J Plast Reconstr Aesthet Surg. 2016;69(3):295–304.PubMedCrossRefGoogle Scholar
  8. 8.
    van der Vleuten CJM, Kater A, Wijnen MHWA, Schultze Kool LJ, Rovers MM. Effectiveness of sclerotherapy, surgery, and laser therapy in patients with venous malformations: a systematic review. Cardiovasc Interv Radiol. 2014;37(4):977–89.Google Scholar
  9. 9.
    Ali S, Mitchell SE. Outcomes of venous malformation sclerotherapy: a review of study methodology and long-term results. Semin Interv Radiol. 2017;34(3):288–93.CrossRefGoogle Scholar
  10. 10.
    Mimura H, et al. Polidocanol sclerotherapy for painful venous malformations: evaluation of safety and efficacy in pain relief. Eur Radiol. 2009;19(10):2474–80.PubMedCrossRefGoogle Scholar
  11. 11.
    Park HS, et al. Clinical outcome and predictors of treatment response in foam sodium tetradecyl sulfate sclerotherapy of venous malformations. Eur Radiol. 2016;26(5):1301–10.PubMedCrossRefGoogle Scholar
  12. 12.
    Mendonca DA, McCafferty I, Nishikawa H, Lester R. Venous malformations of the limbs: the Birmingham experience, comparisons and classification in children. J Plast Reconstr Aesthet Surg. 2010;63(3):383–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Berenguer B, Burrows PE, Zurakowski D, Mulliken JB. Sclerotherapy of craniofacial venous malformations: complications and results. Plast Reconstr Surg. 1999;104(1):1–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Goyal M, Causer PA, Armstrong D. Venous vascular malformations in pediatric patients: comparison of results of alcohol sclerotherapy with proposed MR imaging classification. Radiology. 2002;223(3):639–44.PubMedCrossRefGoogle Scholar
  15. 15.
    Nakamura M, et al. Percutaneous sclerotherapy for venous malformations in the extremities: clinical outcomes and predictors of patient satisfaction. Springerplus. 2014;3:520.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Yun W-S, et al. Predictors of response to percutaneous ethanol sclerotherapy (PES) in patients with venous malformations: analysis of patient self-assessment and imaging. J Vasc Surg. 2009;50(3):581–9 589.e1.PubMedCrossRefGoogle Scholar
  17. 17.
    Horbach SER, van de Ven JS, Nieuwkerk PT, Spuls PI, van der Horst CMAM, Reekers JA. Patient-reported outcomes of bleomycin sclerotherapy for low-flow vascular malformations and predictors of improvement. Cardiovasc Interv Radiol. 2018;41(10):1494–504.CrossRefGoogle Scholar
  18. 18.
    Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL. Cirse quality assurance document and standards for classification of complications: the cirse classification system. Cardiovasc Interv Radiol. 2017;40(8):1141–6.CrossRefGoogle Scholar
  19. 19.
    van der Linden E, Pattynama PMT, Heeres BC, de Jong SC, Hop WCJ, Kroft LJM. Long-term patient satisfaction after percutaneous treatment of peripheral vascular malformations. Radiology. 2009;251(3):926–32.PubMedCrossRefGoogle Scholar
  20. 20.
    Asdahl KR, Hedelund L, Keller J, Baad-Hansen T, Damsgaard T. Outcome measures after sclerotherapy of venous malformations: a systematic review. Cardiovasc Interv Radiol. 2018;41(8):1141–51.CrossRefGoogle Scholar
  21. 21.
    Ono Y, et al. Cost-effectiveness analysis of percutaneous sclerotherapy for venous malformations. J Vasc Interv Radiol. 2016;27(6):831–7.PubMedCrossRefGoogle Scholar
  22. 22.
    Puig S, Aref H, Chigot V, Bonin B, Brunelle F. Classification of venous malformations in children and implications for sclerotherapy. Pediatr Radiol. 2003;33(2):99–103.PubMedCrossRefGoogle Scholar
  23. 23.
    Jin Y, et al. Craniofacial venous malformations: magnetic resonance imaging features that predict treatment outcome. J Oral Maxillofac Surg. 2009;67(11):2388–96.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Diagnostic Imaging Department, Sheba Medical Center, Tel Hashomer, Affiliated to “Sackler” School of MedicineTel-Aviv UniversityTel-AvivIsrael

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