Sclerotherapy complications of peripheral venous malformations.
Background Sclerotherapy is often the primary treatment for peripheral venous malformations. It is mostly sufficient alone, but can be combined with other endovascular techniques. Despite its mini-invasiveness, it is not without potentially severe complications. Here, we systematically report sclerotherapy complications in trunk and extremity venous malformations. Methods We retrospectively assessed the complications of 127 consecutive patients who had received sclerotherapy for peripheral venous malformation in our tertiary care unit (January 2007-August 2013). We applied the Clavien-Dindo classification to grade the severity of complications. We mostly used detergent sclerosants (85.7%), and less often ethanol (5.7%) or bleomycin (4.2%). In 4.2% of the procedures, we combined glue, coils, endovascular laser or particles to sclerotherapy. Results The overall complication rate per procedure was 12.5%. Most complications (83.3%) were local and managed conservatively. We encountered four severe complications, all related to blood coagulopathy. Subcutaneous lesion location and use of ethanol significantly increased the risk of local complications. Conclusion Sclerotherapy alone or combined with other endovascular techniques is a safe method for local venous malformations with moderate risk for conservatively manageable complications. Blood coagulopathy constitutes a risk for, otherwise rare, severe complications.
1 Department of Radiology, University of Helsinki, HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland.
Johanna
J
Aronniemi
2 Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland.
Eeva
E
Castrén
1 Department of Radiology, University of Helsinki, HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland.
Kimmo
K
Lappalainen
3 Department of Plastic Surgery, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland.
Pia
P
Vuola
4 Department of Pediatric Surgery, University of Helsinki, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Päivi
P
Salminen
2 Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland.
Anne
A
Pitkäranta
1 Department of Radiology, University of Helsinki, HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland.
Johanna
J
Pekkola
D000293:Adolescent; D000328:Adult; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D015911:Sclerotherapy / Q000009:adverse effects*; D054079:Vascular Malformations / Q000628:therapy*
D012597:Sclerosing Solutions
Venous malformation; complications; consumption coagulopathy; interventional radiology; sclerotherapy