title: Current concepts in diagnosis and treatment of venous malformations.
abstract: BACKGROUND
  Venous malformations are the most common type of vascular malformation, usually detected at birth or during puberty. By occurring during human growth or through localized trauma, pain, functional impairment and aesthetic disfigurement is often observed. Ultrasonography, Doppler flow Imaging, and Magnetic Resonance Imaging are the most informative techniques which reveal the extent of tissue involvement and differentiate between high and low flow anomalies. Therapeutic options for treatment of venous malformations are sclerotherapy with alcohol, ethoxysclerol and bleomycin, laser therapy (Nd:YAG), surgery and combined therapeutic modalities. The aim of percutaneous sclerotherapy is the successive reduction of the volume of the lesion by aseptic inflammation.
  
  
  METHODS
  This is a review of 51 patients with venous malformation treated by the Interdisciplinary Center for Vascular Anomalies at the University Hospital Tübingen, (Germany), from July, 2002 until January, 2007. The mean age of first consultation in our outpatient department was 26.4 years (median). 12 patients were treated by sclerotherapy with highly concentrated alcohol, 9 by surgery, and 7 by laser therapy. In some cases we combined different treatments. 9 patients had only sclerotherapy, while 3 had a combination of pre-operative sclerotherapy and surgery.
  
  
  RESULTS
  We obtained positive results in patients treated with sclerotherapy and combined sclerotherapy and surgery.
  
  
  CONCLUSIONS
  Sclerotherapy is safe (under fluoroscopic control), efficient, and can be repeated multiple times. Therefore, it should be considered as first-line treatment in venous malformations. A combination of a sclerotherapy with surgery is also useful in many cases.
authors: Department of Oral and Maxillofacial Surgery (Head: Professor Dr. Dr. J. Wiltfang), University Hospital Schleswig-Holstein, Campus Kiel, Osianderstr. 2-8, D-72076 Kiel, Germany. Electronic address: neuschl@mkg.uni-kiel.de.
authors: Neuschl
authors: N
authors: Judith
authors: Department of Diagnostic and Interventional Neuroradiology (Head: Professor Dr. U. Ernemann), University Hospital Tübingen, Hoppe-Seyler-Straße 3, D-72076 Tübingen, Germany.
authors: Ernemann
authors: E
authors: Ulrike
authors: Department of Oral and Maxillofacial Surgery (Head: Professor Dr. Dr. S. Reinert), University Hospital Tübingen, Osianderstr. 2-8, D-72076 Tübingen, Germany. Electronic address: Siegmar.Reinert@med.uni-tuebingen.de.
authors: Reinert
authors: R
authors: Siegmar
authors: Department of Oral and Maxillofacial Surgery (Head: Professor Dr. Dr. J. Wiltfang), University Hospital Schleswig-Holstein, Campus Kiel, Osianderstr. 2-8, D-72076 Kiel, Germany.
authors: Neuschl
authors: N
authors: Matthias
authors: Department of Oral and Maxillofacial Surgery (Head: Professor Dr. Dr. J. Hoffmann), University Hospital Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany. Electronic address: juergen.hoffmann@med.uni-heidelberg.de.
authors: Hoffmann
authors: H
authors: Jürgen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001761:Bleomycin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D053685:Laser Therapy / Q000379:methods; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000502:physiology; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods; D018608:Ultrasonography, Doppler / Q000379:methods; D054079:Vascular Malformations / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions; D000077423:Polidocanol; D001761:Bleomycin; D000431:Ethanol; D011092:Polyethylene Glycols
keywords: Aethoxysclerol; Laser therapy; Sclerotherapy; Vascular malformation; Venous malformations