Radio-opaque ethylcellulose-ethanol is a safe and efficient sclerosing agent for venous malformations
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To evaluate the efficacy and safety of gelified ethanol, a newly developed sclerosing agent for slow-flow vascular malformations.
Seventy-nine sclerotherapy procedures were performed on 44 patients with 37 venous malformations, 2 glomuvenous malformations, 2 lymphatic malformations, 2 lymphatico-venous malformations, and 1 Klippel-Trenaunay syndrome. The median injected volume was 1.00 mL/site of injection. Effects of sclerotherapy on pain, functional and cosmetic disturbance were statistically evaluated with a final result score. Local and systemic complications were recorded.
The mean Visual Analogue Scores were 5.20 ± 2.81 before and 1.52 ± 1.25 after treatment (p < 0.001). Functional and aesthetic improvement was achieved in 31/35 patients (89%) and in 33/41 (80%), respectively. Minor local side effects included necrosis with or without issue of ethylcellulose, palpable residue, and hematoma. No systemic side-effects occurred.
Per mL used, radio-opaque gelified ethanol is at least as effective as absolute ethanol. No systemic complication was observed, as only a low dose of ethanol was injected. Indications for sclerotherapy can be widened to areas with higher risk for local side effects (hands and periocular region), as ethanol is trapped in the lesion. Careful injection procedure is though necessary, because only a limited amount of ethylcellulose can be used per puncture.
• Development of a new sclerosing agent for venous malformations.
• Interesting novel way to deliver alcohol to slow-flow vascular malformations.
• Alcohol-based with less local and systemic side-effects.
KeywordsSclerotherapy Interventional radiology Vascular malformation Alcohol Slow-flow
Visual Analogue pain Score
The authors thank Ms Liliana Niculescu for excellent secretarial assistance. MV is supported by grants from F.R.S-FNRS. All affiliations with or financial involvement, from the conception of the study until the publication of the manuscript with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript are completely disclosed. A patent application on radioopaque ethylcellulose ethanol (PCT/FR2006/002213) was deposited on the 28th of September 2006 by Anne Dompmartin, Daniel Labbé and Jacques Théron. These studies were partially supported by the Interuniversity Attraction Poles initiated by the Belgian Federal Science Policy network 6/05; concerted Research Actions (A.R.C)—Convention N° 07/12-005 of the Belgian French Community Ministry and the F.R.S.-FNRS (Fonds de Recherche scientifique) (to M.V., a “Maître de recherche honoraire du F.R.S.-FNRS”).
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