title: Treatment Algorithm and Clinical Outcome of Venous Malformations of the Limbs.
abstract: BACKGROUND
  Venous malformations of the limbs are congenital low-flow vascular anomalies. A treatment is reasonable if they are symptomatic or if a progressive lesion may affect functional structures.
  
  
  OBJECTIVE
  The purpose of this work is the presentation of clinical results after treatment of venous malformations of the limbs according to the standard algorithm used at the University Hospital of Tuebingen, Germany.
  
  
  METHODS
  Between January 2008 and June 2015, patients with venous malformations of the limbs were subjected to either percutaneous sclerotherapy or surgical excision according to this treatment algorithm. Remaining symptoms such as pain level and disturbing appearance before and after treatment as well as overall satisfaction was assessed the earliest 3 months after last treatment.
  
  
  RESULTS
  Thirty-nine patients with venous malformations of the limbs were subjected to either 1 or more percutaneous sclerotherapies (n = 19) or surgical excision (n = 21). There were no serious complications that needed surgical revision. There was a statistically significant reduction in the pain level and disturbing appearance after both sclerotherapy and surgical excision (p < .05) in 30 cases in total. The overall treatment satisfaction was rated 7.9/10 and 8.8/10 after sclerotherapy and surgical excision, respectively.
  
  
  CONCLUSIONS
  A low complication rate with a high patient satisfaction could be achieved after this treatment algorithm for venous malformations of the limbs.
authors.affiliation: *Department of Hand, Plastic and Reconstructive Surgery, BG Trauma Center, Eberhard-Karls University Tuebingen, Schnarrenbergstr, Tuebingen, Germany; †Department of Neuroradiology, Eberhard-Karls University Tuebingen, Otfried-Müller-Straße, Tuebingen, Germany.
authors.forename: Theodora
authors.initials: T
authors.lastname: Manoli
authors.forename: Manuela
authors.initials: M
authors.lastname: Micheel
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ernemann
authors.forename: Hans-Eberhard
authors.initials: HE
authors.lastname: Schaller
authors.forename: Stéphane
authors.initials: S
authors.lastname: Stahl
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D000066491:Clinical Decision-Making; D005121:Extremities / Q000098:blood supply*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018579:Patient Selection; D015911:Sclerotherapy; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000628:therapy*; D014680:Veins / Q000002:abnormalities*; D055815:Young Adult