title: Ultrasound-guided intralesional diode laser treatment of congenital extratruncular venous malformations: mid-term results.
abstract: OBJECTIVE
  Over the short term, endovenous laser ablation (EVLA) has been found to be safe and effective for endovenous ablation in extratruncular venous malformations (EVMs). We report our experiences in percutaneous ultrasound (US)-guided treatment of congenital EVMs with respect to effectiveness and safety over the mid-term.
  
  
  METHODS
  This was a retrospective analysis of a collected database of consecutive US-guided intralesional diode laser treatments of congenital EVMs (2007-2013). A consecutive series of 164 patients (86 women/girls [53%] and 78 men/boys [46%], aged 1.5-68.0 years [mean age 20.78 years]) were treated using EVLA for congenital EVMs at our institution. All of the patients were symptomatic. The primary outcomes for assessing safety were mortality and morbidity, including laser-related adverse events, thrombotic events, and important nerve or vessel injuries, and so on. Effectiveness was assessed according to reduction of the mass, the absence of pain, and technical success.
  
  
  RESULTS
  One hundred and ninety procedures were undertaken in 164 patients, achieving a 100% immediate technical success rate. Most complications were minor and improved quickly, except in one patient, who suffered a peroneal nerve injury. Spot skin burn injuries occurred in one procedure (0.53%). Paresthesia in the treated area was noted after 15 procedures (7.89%). For complaints related to swelling, cosmetic outcomes, and pain, the clinical success rates were 65.71%, 68.97% and 97.74%, respectively. After a mean follow-up of 23.91 months, no patient suffering from pain, hemorrhage, or limited range of motion had returned with recurrent symptoms after initial successful treatment (resolved). Recurrence rates in patients with heavy sensation, swelling, and deformity were 6.89% (two of 29), 7.41% (two of 27), and 11.11% (one of nine), respectively. One hundred and twelve (59.00%) treated lesion areas were classified as "excellent", 59 lesions (31.00%) were "good", and 19 lesions (10.00%) were "fair" using duplex US imaging at the final follow-up visit.
  
  
  CONCLUSIONS
  EVLA is a minimally invasive treatment with the advantages of safety, effectiveness, and simplicity in ameliorating symptoms associated with EVMs in appropriately selected patients.
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: G
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: X
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: H
authors.initials: H
authors.lastname: Shi
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: K
authors.initials: K
authors.lastname: Ye
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: M
authors.initials: M
authors.lastname: Yin
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: Y
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: X
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: X
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
authors.forename: M
authors.initials: M
authors.lastname: Lu
authors.affiliation: Department of Vascular Surgery, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Institute of Traumatic Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China. Electronic address: mierjiang2014@163.com.
authors.forename: M
authors.initials: M
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D053685:Laser Therapy / Q000379:methods; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*; D054079:Vascular Malformations / Q000175:diagnosis / Q000601:surgery*; D014680:Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D055815:Young Adult
keywords: Congenital venous malformation; Laser; Ultrasound