European Radiology

, Volume 27, Issue 6, pp 2482–2488 | Cite as

Ethanolgel sclerotherapy of venous malformations improves health-related quality-of-life in adults and children – results of a prospective study

  • Walter A. WohlgemuthEmail author
  • Rene Müller-Wille
  • Veronika Teusch
  • Simone Hammer
  • Moritz Wildgruber
  • Wibke Uller



To assess the treatment-induced changes of health-related quality-of-life (HRQoL) in patients with venous malformations (VM) who underwent ethanol gel sclerotherapy.


The prospective study in children and adults was approved by the local ethics committee. 31 patients (mean age 23.42 years, range 6.6 – 46.5; 26 female, 5 male) with VM were included. Patients’ self-assessed HRQoL was measured before and after treatment using psychometrically validated questionnaires for adults and children. Differences were analysed with a paired t test.


58 sclerotherapy sessions were performed. The Physical Component Summary (PCS) at baseline was 43.69 and increased significantly (p = 0.01122) to 48.95 after treatment. The bodily pain (BP) scale increased significantly from 37.94 to 48.56 (p = 0.00002), the general health (GH) scale increased significantly from 46.69 to 52.17 (p = 0.00609). Baseline Physical Summary Score (PHS) in children increased significantly after treatment (p < 0.00001) from 25.25 to 45.89. The baseline Psychosocial Summary Score (PSS) in children was 51.08 and increased significantly (p = 0.00031) after treatment to 58.84.


Paediatric and adult patients with VM suffer from bodily pain with overall reduced physical functioning. After sclerotherapy, these restrictions are successfully returning to normal levels with a positive effect on mental and psychosocial domains.

Key points

Sclerotherapy in venous malformation patients has an unknown effect on health-related quality-of-life

Prospective study showed improvements in bodily pain and general health in adults

Children and adults improved from treatment with ethanol gel

Sclerotherapy is an appropriate therapy


Vascular malformation Sclerotherapy Quality of life Children Adults 



The scientific guarantor of this publication is WAW. WAW, WU and RMW declare relationships with the following companies: ab medica, Düsseldorf, Germany (lecturing, proctoring). The authors state that this work has not received any funding. WAW has significant statistical expertise. Institutional review board approval from the Ethikkommission an der Universität Regensburg was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, longitudinal study, performed at one institution.


  1. 1.
    Wassef M, Blei F, Adams D, Alomari A, Baselga E, Berenstein A et al (2015) Vascular anomalies classification: recommendations from the International Society for the Study of Vascular Anomalies. Pediatrics 136:e203–e214Google Scholar
  2. 2.
    Vogel SA, Hess CP, Dowd CF, Hoffman WY, Kane AJ, Rajaii R et al (2013) Early versus later presentations of venous malformations: where and why? Pediatr Dermatol 30:534–540Google Scholar
  3. 3.
    Lee BB, Baumgartner I, Berlien P, Bianchini G, Burrows P, Gloviczki P et al (2015) Diagnosis and treatment of venous malformations. Consensus document of the International Union of Phlebology (IUP): updated 2013. Int Angiol 34:97–149Google Scholar
  4. 4.
    Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG et al (2007) Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg 45:S5–S67Google Scholar
  5. 5.
    Schumacher M, Dupuy P, Bartoli JM, Ernemann U, Herbreteau D, Ghienne C et al (2011) Treatment of venous malformations: first experience with a new sclerosing agent–a multicenter study. Eur J Radiol 80:e366–e372Google Scholar
  6. 6.
    Sannier K, Dompmartin A, Théron J, Labbé D, Barrellier MT, Leroyer R et al (2004) A new sclerosing agent in the treatment of venous malformations. study on 23 cases. Interv Neuroradiol 10:113–127Google Scholar
  7. 7.
    Saris-Baglama RN, Dewey CJ, Chisholm GB, Plumb E, King J, Rasicot P et al (2011) Quality metric health outcomes scoring software 4.5 – users guide. Quality Metric Inc. LincolnGoogle Scholar
  8. 8.
    Ware JE Jr, Kosinski M, Dewey JE (2000) How to score version 2 of the SF-36® Health Survey. QualityMetric Inc, LincolnGoogle Scholar
  9. 9.
    Landgraf JM, Abetz L, Ware JE (1996) The CHQ: a user's manual, 1st edn. The Health Institute, BostonGoogle Scholar
  10. 10.
    Taft C, Karlsson J, Sullivan M (2001) Do SF-36® summary component scores accurately summarize subscale scores? Qual Life Res 10:395–404CrossRefPubMedGoogle Scholar
  11. 11.
    Balakrishnan K, Bauman N, Chun RH, Darrow DH, Grimmer JF, Perkins JA et al (2015) Standardized outcome and reporting measures in pediatric head and neck lymphatic malformations. Otolaryngol Head Neck Surg 152:948–953Google Scholar
  12. 12.
    Burrows PE, Mason KP (2004) Percutaneous treatment of low flow vascular malformations. J Vasc Interv Radiol 15:431–445CrossRefPubMedGoogle Scholar
  13. 13.
    Weinstein JM, Chamlin SL (2005) Quality of life in vascular anomalies. Lymphat Res Biol 8:256–260CrossRefGoogle Scholar
  14. 14.
    Van der Pleog HM, van der Ploeg MN, van der Ploeg-Stapert JD (1995) Psychological aspects of the Klippel-Trenaunay syndrome. J Psychosom Res 39:183–191CrossRefGoogle Scholar
  15. 15.
    Boetes C, Boll AP, Hartman PH, van Oostrom CG, Rieu PN, de Rooij M et al (1997) Klippel-Trenaunay-type congenital angiodysplasia syndrome; medical and psychological aspects. Ned Tijdschr Geneeskd 141:650–651Google Scholar
  16. 16.
    Van der Linden E, Pattynama PM, Heeres BC, de Jong SC, Hop WC, Kroft LJ (2009) Long-term patient satisfaction after percutaneous treatment of peripheral vascular malformations. Radiology 251:926–932CrossRefPubMedGoogle Scholar
  17. 17.
    Oduber CEU, Khemlani K, Smitt JHS, Hennekam RCM, van der Horst CMAM (2010) Baseline quality of life in patients with Klippel-Trenaunay syndrome. J Plast Reconstruct Aesthet Surg 63:603–609CrossRefGoogle Scholar
  18. 18.
    Geirdal AØ, Dheyauldeen S, Bachmann-Harildstad G, Heimdal K (2012) Quality of life in patients with hereditary hemorrhagic telangiectasia in Norway: a population based study. Am J Med Genet A 158A:1269–1278CrossRefPubMedGoogle Scholar
  19. 19.
    Breugem CC, Merkus MP, Smitt JH, Legemate DA, van der Horst CM (2004) Quality of life in patients with vascular malformations of the lower extremity. Br J Plast Surg 57:754–763CrossRefPubMedGoogle Scholar
  20. 20.
    Rautio R, Laranne J, Kähärä V, Saarinen J, Keski-Nisula L (2004) Long-term results and quality of life after endovascular treatment of venous malformations in the face and neck. Acta Radiol 45:738–745CrossRefPubMedGoogle Scholar
  21. 21.
    Rautio R, Saarinen J, Laranne J, Salenius JP, Keski-Nisula L (2004) Endovascular treatment of venous malformations in extremities: results of sclerotherapy and the quality of life after treatment. Acta Radiol 45:397–403CrossRefPubMedGoogle Scholar
  22. 22.
    Ware JE Jr, Harris WJ, Gandek B, Rogers BW, Reese PR (1997) MAP-R for Windows: Multitrait/multi-item scale analysis software. Health Assessment Lab, BostonGoogle Scholar

Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Walter A. Wohlgemuth
    • 1
    Email author
  • Rene Müller-Wille
    • 1
  • Veronika Teusch
    • 1
  • Simone Hammer
    • 1
  • Moritz Wildgruber
    • 2
  • Wibke Uller
    • 1
  1. 1.Institut für RöntgendiagnostikUniversitätsklinikum RegensburgRegensburgGermany
  2. 2.Institut für klinische RadiologieUniversitätsklinikum Münster, Westfälische Wilhelms UniversitätMünsterGermany

Personalised recommendations