Premium
Sonographically guided percutaneous sclerosis using 1% polidocanol in the treatment of vascular malformations
Author(s) -
Jain Rajeev,
Bandhu Suman,
Sawhney Sukhpal,
Mittal Ravi
Publication year - 2002
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.10091
Subject(s) - medicine , polidocanol , venous malformation , percutaneous , embolization , radiology , arteriovenous malformation , aneurysmal bone cyst , surgery , pseudoaneurysm , lesion , vascular malformation , sclerotherapy , aneurysm
Purpose The aim of this prospective study was to assess the safety and efficacy of sonographically guided percutaneous injection of 1% polidocanol for sclerosis of peripheral vascular malformations. Methods Patients with vascular malformations of soft tissues were invited to enroll in the study. Gray‐scale and color Doppler sonography were performed to determine the texture, margins, and size of the lesions and to determine whether high‐velocity blood flow was present. Using real‐time sonographic guidance, lesions were punctured with a 20/21‐gauge spinal needle. When possible, venous return was occluded before injection. For each injection, 1–6 ml of 1% polidocanol was injected into 1 or more sites within the lesion. The sclerosing agent was not aspirated after injection. Repeat radiography was performed 1 month after each injection session. The procedure was repeated if the patient did not have a complete response, defined as an 80% or greater decrease in the volume of the lesion or resolution of the presenting symptoms. Results Of the 15 patients enrolled, 9 had venous malformations, 3 had lymphangiomas, 1 had a recurrent aneurysmal bone cyst, 1 had a venous pseudoaneurysm, and 1 had an arteriovenous malformation of the pinna. Each patient received 1–20 injections of 1% polidocanol (mean ± standard deviation, 3.3 ± 4.8 injections). This treatment resulted in a complete response of 7 venous malformations, 3 lymphangiomas, and the arteriovenous malformation and partial response of 2 venous malformations, the recurrent aneurysmal bone cyst, and the venous pseudoaneurysm. Only minor complications occurred. Conclusions Sonographically guided percutaneous injection of 1% polidocanol for sclerosis of peripheral vascular lesions is simple, effective, and safe. This technique is especially effective in cases of soft tissue venous malformation and lymphangioma. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:416–423, 2002