title: Radio-opaque ethylcellulose-ethanol is a safe and efficient sclerosing agent for venous malformations.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of gelified ethanol, a newly developed sclerosing agent for slow-flow vascular malformations.
  
  
  METHODS
  Seventy-nine sclerotherapy procedures were performed on 44 patients with 37 venous malformations, 2 glomuvenous malformations, 2 lymphatic malformations, 2 lymphatico-venous malformations, and 1 Klippel-Trenaunay syndrome. The median injected volume was 1.00 mL/site of injection. Effects of sclerotherapy on pain, functional and cosmetic disturbance were statistically evaluated with a final result score. Local and systemic complications were recorded.
  
  
  RESULTS
  The mean Visual Analogue Scores were 5.20  ±  2.81 before and 1.52  ±  1.25 after treatment (p < 0.001). Functional and aesthetic improvement was achieved in 31/35 patients (89%) and in 33/41 (80%), respectively. Minor local side effects included necrosis with or without issue of ethylcellulose, palpable residue, and hematoma. No systemic side-effects occurred.
  
  
  CONCLUSIONS
  Per mL used, radio-opaque gelified ethanol is at least as effective as absolute ethanol. No systemic complication was observed, as only a low dose of ethanol was injected. Indications for sclerotherapy can be widened to areas with higher risk for local side effects (hands and periocular region), as ethanol is trapped in the lesion. Careful injection procedure is though necessary, because only a limited amount of ethylcellulose can be used per puncture. Key Points • Development of a new sclerosing agent for venous malformations. • Interesting novel way to deliver alcohol to slow-flow vascular malformations. • Alcohol-based with less local and systemic side-effects.
authors.affiliation: Department of Dermatology, Université de Caen Basse Normandie, CHU Caen, Av Georges Clémenceau, 14033 Caen, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Dompmartin
authors.forename: Xavier
authors.initials: X
authors.lastname: Blaizot
authors.forename: Jacques
authors.initials: J
authors.lastname: Théron
authors.forename: Frank
authors.initials: F
authors.lastname: Hammer
authors.forename: Yannick
authors.initials: Y
authors.lastname: Chene
authors.forename: Daniel
authors.initials: D
authors.lastname: Labbé
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Barrellier
authors.forename: Cathy
authors.initials: C
authors.lastname: Gaillard
authors.forename: Robert
authors.initials: R
authors.lastname: Leroyer
authors.forename: Valérie
authors.initials: V
authors.lastname: Chedru
authors.forename: Catherine
authors.initials: C
authors.lastname: Ollivier
authors.forename: Miikka
authors.initials: M
authors.lastname: Vikkula
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Boon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002482:Cellulose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007715:Klippel-Trenaunay-Weber Syndrome / Q000628:therapy; D042601:Lymphatic Vessels / Q000002:abnormalities; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000175:diagnosis / Q000628:therapy*; D014680:Veins / Q000002:abnormalities* / Q000473:pathology; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions; D000431:Ethanol; C013517:ethyl cellulose; D002482:Cellulose