title: Sclerotherapy of Diffuse and Infiltrative Venous Malformations of the Hand and Distal Forearm.
abstract: OBJECTIVE
  Venous malformations (VM) involving the hand and forearm often lead to chronic pain and dysfunction, and the threshold for treatment is high due to the risk of nerve and skin damage, functional deterioration and compartment syndrome. The purpose of this study is to demonstrate that sclerotherapy of diffuse and infiltrative VM of the hand is a safe and effective therapy.
  
  
  METHODS
  A retrospective review of all patients with diffuse and infiltrative VM of the hand and forearm treated with sclerotherapy from 2001 to 2014 was conducted. All VM were diagnosed during the clinical visit by a combination of physical examination and imaging. Sclerotherapy was performed under imaging guidance using ethanol and/or sodium tetradecyl sulfate foam. Clinical notes were reviewed for signs of treatment response and complications, including skin blistering and nerve injury.
  
  
  RESULTS
  Seventeen patients underwent a total of 40 sclerotherapy procedures. Patients were treated for pain (76%), swelling (29%) or paresthesias (6%). Treatments utilized ethanol (70%), sodium tetradecyl sulfate foam (22.5%) or a combination of these (7.5%). Twenty-four percent of patients had complete resolution of symptoms, 24% had partial relief of symptoms without need for further intervention, and 35% had some improvement after initial treatment but required additional treatments. Two skin complications were noted, both of which resolved. No motor or sensory loss was reported.
  
  
  CONCLUSIONS
  Sclerotherapy is a safe and effective therapy for VM of the hand with over 83% of patients experiencing relief.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Boulevard, Box 8131, St. Louis, MO, 63110, USA. guevarac@mir.wustl.edu.
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Guevara
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Boulevard, Box 8131, St. Louis, MO, 63110, USA.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Gonzalez-Araiza
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Boulevard, Box 8131, St. Louis, MO, 63110, USA.
authors.forename: Seung K
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Boulevard, Box 8131, St. Louis, MO, 63110, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sheybani
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Boulevard, Box 8131, St. Louis, MO, 63110, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Darcy
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006225:Hand / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage; D015911:Sclerotherapy; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000628:therapy*; D014680:Veins / Q000002:abnormalities*; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions; D000431:Ethanol; D012981:Sodium Tetradecyl Sulfate
keywords: Sclerotherapy; Venous malformation