Experience of sclerotherapy and embolosclerotherapy using ethanolamine oleate for vascular malformations of the head and neck.
Sclerotherapy is effective in the treatment of vascular malformations. However, in lesions with relatively high blood flow, its effect is not always adequate. We therefore developed a three-grade classification of vascular malformations to facilitate the selection of treatments according to vascular flow. We also developed the technique of embolosclerotherapy, in which transarterial embolisation is done before sclerotherapy to control blood flow in the lesion during sclerotherapy. We now have 14 years' experience with 112 cases of vascular malformations of the head and neck treated with sclerotherapy. Results were evaluated with pretreatment and post-treatment photographs, and reduction of volume was calculated on findings from magnetic resonance imaging. Clinical improvement in 110 cases was graded as excellent in 32 (29%), good in 48 (43%), fair in 19 (17%), and poor in 11 (10%). In 84 cases, mean rate of reduction of volume was 35%. The most common complication was haemolytic haemoglobinuria (n=37, 33%). Our results suggest that this three-grade classification is useful to judge resistance to sclerotherapy and decide on treatment. Our experience indicates that ethanolamine oleate (EO), with or without arterial embolisation, was effective using our classification of vascular dynamics. We consider EO to be equivalent or superior to other sclerosants such as ethanol.
Kaji
Nobuyuki
N
Department of Plastic Surgery, Kyorin University School of Medicine, Tokyo, Japan.
Kurita
Masakazu
M
Ozaki
Mine
M
Takushima
Akihiko
A
Harii
Kiyonori
K
Narushima
Mitsunaga
M
Wakita
Shinichi
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001165:Arteriovenous Malformations / Q000503:physiopathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic; D006257:Head; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009333:Neck; D009829:Oleic Acids / Q000627:therapeutic use*; D012039:Regional Blood Flow; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy; D054079:Vascular Malformations / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult
D009829:Oleic Acids; D012597:Sclerosing Solutions; C033343:ethanolamine oleate