Percutaneous sclerotherapy of vascular malformations in children using sodium tetradecyl sulphate: the Birmingham experience.
OBJECTIVE
Sclerotherapy has become first line treatment for most venous malformations and some lymphatic malformations. We aimed to measure our sclerotherapy treatment success using 3% sodium tetradecyl sulphate (STD) and describe our experience.


METHODS
Retrospective five year review (Jan 04-09) of children with vascular malformations treated at our centre with 3% STD. Patients were classified using the Birmingham classification and treatment success was measured through case note review and pre- and post-treatment photographs. FINDINGS AND RESULTS: Forty-three (84.3%) of the 51 patients with vascular malformations (VM) who underwent sclerotherapy derived a benefit. Twelve patients (23.5%) had an excellent result, 31 (60.8%) were improved whilst eight (15.7%) were unchanged. Using Fisher's exact test, there was a statistically significant difference in achieving complete resolution of superficial VMs compared to lesions involving the deeper layers of the head and neck. 17.6% of patients developed a complication with an overall complication rate of 12.2% per injection. There was one major complication with the remainder consisting of superficial skin necrosis that resolved conservatively.


CONCLUSIONS
Treatment with 3% STD sclerotherapy is effective in venous and some lymphatic vascular malformations. It should be considered an important treatment modality within a multi-disciplinary setting in these difficult problems.
Department of Plastic and Reconstructive Surgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, West Midlands, United Kingdom. kennethkok@gmail.com
Kenneth
K
Kok
Ian
I
McCafferty
Andrew
A
Monaghan
Hiroshi
H
Nishikawa
D000293:Adolescent; D001165:Arteriovenous Malformations / Q000145:classification / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods*; D012981:Sodium Tetradecyl Sulfate / Q000627:therapeutic use*; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate