Percutaneous sodium tetradecyl sulfate sclerotherapy for peripheral venous vascular malformations: a single-center experience.
OBJECTIVE
To evaluate the efficacy, safety, and long-term outcomes of percutaneous sodium tetradecyl sulfate (STS)sclerotherapy for peripheral venous vascular malformations (VVMs).


METHODS
A retrospective review of a prospectively compiled database was performed to identify patients with a VVM who were referred from 1997 to 2004. Of the 132 patients identified, 78 underwent sclerotherapy. Six of the 78 patients were lost to follow-up. Of the remaining 72 patients (24 male and 48 female patients; mean age, 31.7 years; age range, 14-62 years), 42 (58%) had lower limb VVMs, 19 (26%) had upper limbVVMs, and nine (12%) had truncal and/or central VVMs. Two patients (2.8%) had multifocal lesions. Seven of the 72 patients (9.7%) had Klippel-Trénauney syndrome. Treatment response was assessed clinically and by means of lesion size measurement with magnetic resonance (MR) imaging.


RESULTS
A total of 226 treatment sessions were performed (mean, 3.1 sessions per patient; range, 1-13 sessions). The mean follow-up was 41 months (range, 21-84 months). After treatment, 11 patients (15%) became asymptomatic, 20(28%) rated the response to therapy as good, 17 (24%) improved, 20 (28%) were unchanged, and four (5.6%) worsened.Thirty-five patients underwent MR imaging before and after treatment. The size of the VVM was seen to decrease in19 patients (54%), be unchanged in 11 (31%), and increase in five (14%). A reduction in lesion size at MR imaging did not necessarily correlate with a positive clinical response. Overall, patients with infiltrative lesions had a poorer outcome than did those with localized lesions. There were no major complications and seven minor complications(3.1% per session, 9.7% per patient).


CONCLUSIONS
An improvement in symptoms was observed in 70% of the patients with VVMs treated with percutaneous STS. Although the treatment is safe, complete cure is unusual and multiple treatment sessions are almost always required.
Tan
Kong T
KT
Division of Interventional Radiology, Medical Imaging Department, University Health Network, 585 University Ave, Toronto, Ontario M5G2N2, Canada. kongtengtan@hotmail.com
Kirby
John
J
Rajan
Dheeraj K
DK
Hayeems
Eran
E
Beecroft
John R
JR
Simons
Martin E
ME
D000279:Administration, Cutaneous; D000328:Adult; D002170:Canada / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage; D015911:Sclerotherapy / Q000379:methods* / Q000706:statistics & numerical data*; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage*; D016896:Treatment Outcome; D014680:Veins / Q000002:abnormalities* / Q000187:drug effects*
D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate