title: Percutaneous sclerotherapy of foot venous malformations: evaluation of clinical response.
abstract: OBJECTIVE
  To evaluate a single institutional experience with percutaneous sclerotherapy of venous malformations (VM) of the foot.
  
  
  METHODS
  Sixteen patients (mean age 14.6 years; range 6-27.3 years), who underwent 34 sclerotherapy procedures were retrospectively analysed. Technical success, Puig classification, VM size reduction, and the complication rate were evaluated. In procedures in which C-arm computed tomography (CT) was performed, the VM-to-skin surface distance was measured. Additionally, an e-mail-based questionnaire to evaluate the response to sclerotherapy was answered by the patients.
  
  
  RESULTS
  Technical success was 97%. The mean number of procedures per patient was 2.1 (range 1-5). In all procedures, sodium tetradecyl sulphate foam was used. Appropriate follow-up was available for 29/33 procedures (88%). Post-procedural complications occurred after 6/29 procedures (21%), all of which were self-limited skin complications. C-arm CT was performed in 19/33 procedures (58%). The lesion-to-skin surface distance was significantly shorter in patients with skin post-procedural complications (p < 0.001). The e-mail-based questionnaire was completed by 13/16 patients (81%). Decrease in swelling, improvement of foot function and a significant decrease in pain (p = 0.003) was reported. No patient reported dis-improvement after sclerotherapy.
  
  
  CONCLUSIONS
  Percutaneous sclerotherapy is an effective option for treating foot VMs. Skin complication rates are higher with shorter VM-to-skin surface distance.
authors.affiliation: Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. Electronic address: jorge.delgado.londono@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Delgado
authors.affiliation: Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Bedoya
authors.affiliation: Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Gaballah
authors.affiliation: Department of Plastic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: D W
authors.initials: DW
authors.lastname: Low
authors.affiliation: The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Department of Interventional Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Cahill
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005534:Foot Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D012597:Sclerosing Solutions