Outpatient percutaneous treatment of deep venous malformations using pure ethanol at low doses under local anesthesia.
BACKGROUND
Venous malformations are the most frequent vascular malformation. Deep venous malformations are located in subcutaneous tissue or in the muscles. Percutaneous sclerotherapy is the treatment of choice, and the use of ethanol at low doses has not yet been described.


OBJECTIVE
To analyze the results of treating Deep venous malformations patients with low doses of ethanol.


METHODS
Thirty-nine patients treated between July 1995 and June 2007 were followed up prospectively over a median period of 18 months. Twenty-nine were female (74.4%) and 10 were male (25.6%), with ages ranging from 11 to 59 years (median of 24 years). All of the lesions affected limbs, and the main symptom reported was pain (97.4%). Each patient underwent fortnightly alcohol application sessions under local anesthesia on an outpatient basis. The lesions were classified into three groups according to size using nuclear magnetic resonance imaging: small, up to 3 cm (4 patients); medium, between 3 and 15 cm (27 patients); and large, greater than 15 cm (8 patients).


RESULTS
The symptoms completely disappeared in 14 patients (35.9%) and improved in 24 (61.5%). The lesion size reduced to zero in 6 patients (15.4%) and decreased in 32 (82%). The median number of sessions was 7. There were no complications in 32 patients (82%), while 3 presented local paresthesia (7.7%), 2 superficial trombophlebites (5.1%), 1 skin ulcer (2.6%), and 1 case of hyperpigmentation (2.6%).


CONCLUSIONS
Outpatient treatment for Deep venous malformations patients using ethanol at low doses was effective, with a low complication rate.
Department of Plastic Surgery, Hospital A.C. Camargo, São Paulo, SP, Brazil.
José Luiz
JL
Orlando
Jose Guilherme Mendes Pereira
JG
Caldas
Heloisa Galvão do Amaral
HG
Campos
Kenji
K
Nishinari
Nelson
N
Wolosker
D000293:Adolescent; D000328:Adult; D000772:Anesthesia, Local; D002648:Child; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000628:therapy*; D055815:Young Adult
D012597:Sclerosing Solutions; D000431:Ethanol