Sclerotherapy of voluminous venous malformation in head and neck with absolute ethanol under digital subtraction angiography guidance.
OBJECTIVE
Venous malformation (VM) is the most common symptomatic low-flow vascular malformation, which predominantly occurs in the head and neck region. The aim of this paper was to evaluate the results of endovascular sclerotherapy of voluminous VM, when the lesion is either >or=15 cm in maximum diameter or the lesion invades more than one anatomical space, in the head and neck region using absolute ethanol under digital subtraction angiography (DSA) guidance.


METHODS
A total of 23 patients with head and neck VMs between October 2005 and December 2008 were retrospectively reviewed. All patients received direct puncture ethanol sclerotherapy under DSA guidance. Follow-up assessments were performed at 3-25 months after therapies were completed, and complications were reported in some cases.


RESULTS
All patients were satisfied with the results of therapy. Seventeen patients (73.9%) achieved excellent responses and six patients (26.1%) achieved good responses in magnetic resonance imaging assessments. Minor complications developed during the procedures, all of which were successfully managed with full recovery during follow-ups. Serious complications such as acute pulmonary hypertension, cardiovascular collapse and pulmonary embolism were not encountered.


CONCLUSIONS
It is concluded that sclerotherapy with absolute ethanol under DSA guidance is an important alternative therapy for voluminous and extensive VM, as the procedure is reasonably safe and offers good therapeutic results.
Wang
Y A
YA
Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhi Zao Ju Road, Shanghai 200011, PR China.
Zheng
J W
JW
Zhu
H G
HG
Ye
W M
WM
He
Y
Y
Zhang
Z Y
ZY
D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006257:Head / Q000098:blood supply; D006801:Humans; D008297:Male; D009333:Neck / Q000098:blood supply; D010690:Phlebography; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014680:Veins / Q000002:abnormalities*; D055815:Young Adult
D012597:Sclerosing Solutions; D000431:Ethanol