title: Pulmonary hypertensive crisis following ethanol sclerotherapy for a complex vascular malformation.
abstract: Anhydrous ethanol is a commonly used sclerotic agent for treating vascular malformations. We describe the case of a full-term 15-day-old female with a complex venolymphatic malformation involving the face and orbit. During treatment of the lesion with ethanol sclerotherapy, she suffered acute pulmonary hypertensive crisis. We discuss the pathophysiology of pulmonary hypertension related to ethanol sclerotherapy, and propose that hemolysis plays a significant role. Recommendations for evaluation, monitoring and management of this complication are also discussed.
authors.affiliation: 1] California Poison Control System, San Francisco Division, University of California, San Francisco, CA, USA [2] Department of Emergency Medicine, Hospital San Juan de Dios, San Jose, Costa Rica.
authors.forename: G
authors.initials: G
authors.lastname: Cordero-Schmidt
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Wallenstein
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Ozen
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: N A
authors.initials: NA
authors.lastname: Shah
authors.affiliation: Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: E
authors.initials: E
authors.lastname: Jackson
authors.affiliation: Interventional Radiology Section, Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Hovsepian
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Palma
mesh_terms: D000431:Ethanol / Q000009:adverse effects*; D005145:Face / Q000098:blood supply; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced*; D007231:Infant, Newborn; D009915:Orbit / Q000098:blood supply; D015911:Sclerotherapy / Q000009:adverse effects*; D054079:Vascular Malformations / Q000628:therapy*
chemical_list: D000431:Ethanol