Incidence of soft tissue injury and neuropathy after embolo/sclerotherapy for congenital vascular malformation.
OBJECTIVE
Embolo/sclerotherapy is an important treatment modality for vascular malformations, but the rates and results of the complications associated with embolo/sclerotherapy are not well known. We report the incidence and outcome of soft tissue injury and neuropathy after performing embolo/sclerotherapy for congenital vascular malformations (CVMs) classified according to the Hamburg classification.


METHODS
Among 1823 patients with CVM, 573 were treated with embolo/sclerotherapy. We retrospectively reviewed 68 patients (31 males, 37 females; mean age, 20.0 years) with soft tissue injury and 49 patients (16 males, 33 females; mean age, 21.2 years) with neuropathy. The indications for embolo/sclerotherapy for CVM were that the CVMs affected the quality of life, such as a symptomatic or trauma-prone lesion or a lesion that was impairing the function of a limb, and the lesions that were located near a life-threatening vital area, including the airway. As embolo/sclerotherapy agents, absolute or 80% ethanol, N-butyl cyanoacrylate (NBCA), and various types of coils or contour particles were used in various combinations, either at the same time or in phases, depending on the location, severity, and extent of the CVM.


RESULTS
The incidence of soft tissue injury was 29.4% (42 of 143) for the arteriovenous shunting type and 8% (22 of 273) for the venous type. No soft tissue injuries occurred in the patients with arterial and lymphatic malformations. Of the 68 patients with soft tissue injury, 40 lesions healed with conservative management, and 28 lesions needed surgery, including escharectomy, skin graft, or amputation. The incidence of neuropathy was 10.9% (30 of 273) for the venous CVM. No neuropathy occurred in the patients with arterial malformations. Of the 49 patients with neuropathy, 42 recovered at a mean period of 5.3 months, but seven did not.


CONCLUSIONS
Soft tissue injuries occurred in 11.9% of patients (68 of 573) and neuropathies occurred in 8.6% (49 of 573) after undergoing embolo/sclerotherapy. Most of these complications recovered by themselves (58.9% from soft tissue injury and 85.1% from neuropathy). Our results suggest that embolo/sclerotherapy has an acceptable incidence of soft tissue injury and neuropathy, when considering the effect that the CVM had on the quality of life before treatment, so embolo/sclerotherapy is recommended as a treatment modality for CVM.
Lee
Kyung-Bok
KB
Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kim
Dong-Ik
DI
Oh
Se-Keon
SK
Do
Young-Soo
YS
Kim
Keon-Ha
KH
Kim
Young-Wook
YW
D000328:Adult; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D015911:Sclerotherapy / Q000009:adverse effects*; D012720:Severity of Illness Index; D017695:Soft Tissue Injuries / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000473:pathology / Q000628:therapy*