[Percutaneous treatment of peripheral vascular malformations with a mixture of polidocanol and CO(2). Initial experience].
OBJECTIVE
The percutaneous treatment of peripheral vascular malformations is currently the first treatment option for these processes. We describe our initial experience using a mixture of polidocanol and CO(2) as an embolizing agent; we analyze the efficacy and complications of the treatment.


METHODS
Between April 2005 and December 2006, we treated a total of 18 patients, comprising 11 women (61%) and 7 men (39%), with ages ranging from 11 to 80 years. One (5%) vascular malformation was hemodynamically active and the remaining 17 (95%) were hemodynamically inactive. We performed a total of 56 embolizations (mean per patient, 3; range, 1-7) using a mixture of polidocanol and CO(2) (mean, 8 cm(3); range, 1-28 cm(3)). The malformations were studied with Doppler ultrasonography, magnetic resonance imaging, and direct puncture angiography and/or arteriography. Specific approaches and treatments were used in each case in function of the location, size, and characteristics of the malformation.


RESULTS
Technical success, defined as the possibility of embolizing the malformation, was achieved in all cases. No technical complications occurred. The mean follow-up period was 9 months (range, 1-20). All patients, except one woman who refused to continue treatment, improved objectively and subjectively, and all were able to return to normal daily activities. After embolization, all patients presented edema, pain, and increased functional incapacity that ceased with medical treatment.


CONCLUSIONS
Percutaneous embolization of vascular malformations using a mixture of polidocanol and CO(2) is efficacious and has a low rate of complications. Our initial results are promising but larger studies are necessary to reach definitive conclusions.
Górriz Gómez
E
E
Unidad de Neurorradiología Intervencionista. Hospital General de Gran Canaria Dr. Negrín. Las Palmas. España.
Carreira
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide / Q000008:administration & dosage*; D002648:Child; D004338:Drug Combinations; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D054079:Vascular Malformations / Q000628:therapy*; D055815:Young Adult
D004338:Drug Combinations; D012597:Sclerosing Solutions; D000077423:Polidocanol; D002245:Carbon Dioxide; D011092:Polyethylene Glycols