title: Effectiveness of sclerotherapy, surgery, and laser therapy in patients with venous malformations: a systematic review.
abstract: OBJECTIVE
  Because the best possible treatment for venous malformations is unclear, this study systematically reviews the available literature regarding the effectiveness of different treatment options for the patient group. Venous malformations result from incorrect development of the veins during embryogenesis and are present at birth. Venous malformations may exhibit symptoms, such as pain, swelling, and inflammation of the vessel.
  
  
  METHODS
  A systematic literature search in PubMed and Embase was performed. Data regarding the design, participants, intervention and, treatment outcome (success and complications) were extracted. The validity of the studies was assessed with the Cochrane Collaboration's risk of bias tool.
  
  
  RESULTS
  Thirty-five studies were identified studying the effectiveness of eight treatments: sclerotherapy/embolization with ethanol, gelified ethanol, bleomycin, polidocanol, sodium tetradecyl sulfate (STS), Ethibloc, surgery, and laser therapy. All of the included studies have a high or unclear risk of bias. The average biased reported success rates for ethanol, gelified ethanol, bleomycin, polidocanol, STS, Ethibloc, surgery, and laser therapy were 74, 89, 88, 90, 86, 65, 90, and 94 %, respectively.
  
  
  CONCLUSIONS
  Until more valid evidence is available, the choice for treatment remains a shared decision between the patient and a multidisciplinary treatment group. From a cost perspective, sclerotherapy with STS or polidocanol should be the treatment of choice.
authors.affiliation: Department of Dermatology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands, c.vandervleuten@derma.umcn.nl.
authors.forename: Carine J M
authors.initials: CJ
authors.lastname: van der Vleuten
authors.forename: Anne
authors.initials: A
authors.lastname: Kater
authors.forename: Marc H W A
authors.initials: MH
authors.lastname: Wijnen
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Schultze Kool
authors.forename: Maroeska M
authors.initials: MM
authors.lastname: Rovers
mesh_terms: D006801:Humans; D053685:Laser Therapy; D012307:Risk Factors; D012597:Sclerosing Solutions; D015911:Sclerotherapy; D054079:Vascular Malformations / Q000628:therapy*; D014656:Vascular Surgical Procedures
chemical_list: D012597:Sclerosing Solutions