Intralesional sclerotherapy for subcutaneous venous malformations in children.
BACKGROUND
Venous malformations (VMs) involve multiple anatomical spaces and encase critical neuromuscular structures, making surgical treatment difficult. Recently sclerotherapy has been suggested as the primary treatment for VMs instead of surgical intervention. This report represents eight cases of children with VMs treated with direct percutaneous injections of sclerosing agents, such as ethanol, polidocanol or ethanolamine oleate.


METHODS
All eight patients had large lesions (>3 cm) located on the head, foot, neck and face. Sclerotherapy was performed in an angiographic suite under general anesthesia. Prior to sclerotherapy, percutaneous phlebography was performed in order to visualize the dynamic situation inside the lesion and the draining flow into the adjacent venous vascular system. A 2-15 ml of sclerosing agent was injected into VM lesions under fluoroscopy.


CONCLUSIONS
An evaluation by MRI examination showed that 6 out of 8 patients had remission, and alleviation of their symptoms without major complications, furthermore one of the lesions apparently disappeared. Intralesional sclerotherapy provides a simple, safe and effective treatment for VMs in the subcutaneous lesions in children.
Uehara
Shuichiro
S
Division of Surgery, Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. uehara@pedsurg.med.osaka-u.ac.jp
Osuga
Keigo
K
Yoneda
Akihiro
A
Oue
Takaharu
T
Yamanaka
Hiroaki
H
Fukuzawa
Masahiro
M
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D015552:Injections, Intralesional; D008279:Magnetic Resonance Imaging; D008297:Male; D009829:Oleic Acids / Q000008:administration & dosage; D010690:Phlebography; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D015911:Sclerotherapy / Q000379:methods; D054079:Vascular Malformations / Q000175:diagnosis / Q000188:drug therapy*; D014680:Veins / Q000002:abnormalities*
D009829:Oleic Acids; D012597:Sclerosing Solutions; D000077423:Polidocanol; D000431:Ethanol; D011092:Polyethylene Glycols; C033343:ethanolamine oleate