Complications of sclerotherapy for 75 head and neck venous malformations.
Sclerotherapy is one treatment option for head and neck venous malformations (VMs). Evaluation of complication risks is, however, essential to improve its safety. We aimed to systematically report sclerotherapy complications by means of the Clavien-Dindo classification and to distinguish factors predisposing to complications. We identified our institution's head and neck VM patients who received sclerotherapy between 1 January 2007 and 31 August 2013, analyzed patient reports retrospectively, and applied to them the Clavien-Dindo classification. Our 75 VM patients underwent a total of 150 sclerotherapy sessions. The most common sclerosants were 3 % sodium tetradecyl sulfate and polidocanol. Complications occurred in 13 patients (17.3 %) and in 15 sessions (10.0 %); 3 complications required extensive postprocedural treatment and caused permanent morbidity, whereas 12 received conservative treatment. Patients with sclerotherapy complications underwent more treatments (p = 0.009) and more often needed further surgery (p = 0.007). We thus consider sclerotherapy a relatively safe treatment modality for head and neck VMs. To avoid complications, evaluation of VM characteristics and optimal treatment technique in a multidisciplinary team is vital.
Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, P.O. Box 220, 00029 HUCH, Helsinki, Finland. eeva.castren@helsinki.fi.
Eeva
E
Castrén
Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
Johanna
J
Aronniemi
Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, P.O. Box 220, 00029 HUCH, Helsinki, Finland.
Tuomas
T
Klockars
Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
Johanna
J
Pekkola
Department of Radiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
Kimmo
K
Lappalainen
Department of Plastic Surgery, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
Pia
P
Vuola
Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
Päivi
P
Salminen
Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, P.O. Box 220, 00029 HUCH, Helsinki, Finland.
Anne
A
Pitkäranta
D000328:Adult; D005260:Female; D005387:Finland; D006257:Head / Q000098:blood supply*; D006801:Humans; D008297:Male; D009333:Neck / Q000098:blood supply*; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000009:adverse effects; D015911:Sclerotherapy / Q000379:methods*; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000175:diagnosis / Q000628:therapy; D014680:Veins / Q000002:abnormalities / Q000187:drug effects
D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols; D012981:Sodium Tetradecyl Sulfate
Clavien-Dindo classification; Safety; Treatment; Vascular anomaly