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Ultrasound‐guided polidocanol foam sclerotherapy for treating venous malformations
Author(s) -
Kumar Subhash,
Bhavana Kranti,
Kumar Sanjeev,
Kumar Prem
Publication year - 2018
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.22546
Subject(s) - polidocanol , medicine , sclerotherapy , ultrasound , venous malformation , surgery , radiology
Aim To evaluate clinical and imaging outcomes after ultrasound (US)‐guided 3% polidocanol (POL) foam‐sclerotherapy of venous malformations (VMs). Methods We retrospectively evaluated consecutive VM cases over 1.5 years, with 6‐month follow‐up. US findings were used to classify VMs into four types depending upon extent of anechoic channels, connections to adjacent veins, and dysmorphism. Single or multiple needles were inserted depending upon lesion size, and used to inject up to 8 mL POL per session, every 2 to 4 weeks. We evaluated reduction in pain and swelling, lesion resolution on imaging, and patient satisfaction. Results There were 15, 24, 9, and 5 patients (total 53) with type I, II, III, and IV VMs, respectively. The average number of sessions was 5.3, 4.3, and 4, and the average amount of POL injected was 14.24 mL, 16.1 mL, and 23.2 mL for type I, II, III VMs, respectively. The number of sessions correlated with lesion volume ( P < .0001). Imaging showed good resolution in 4/15, 18/24, 6/9, and 4/5 patients respectively with type I, II, III, and IV VMs. Patient satisfaction was not related to lesion type ( P = .1). ROC analyses showed cut‐off values of 4.9 mL lesion volume, three sessions, and 12 mL POL volume for patient satisfaction. At 6 months, 23 patients having pain had significant improvement ( P < .00001). Local ( n = 30) and chest pain ( n = 2) were the only complications. Conclusions US‐guided sclerotherapy with 3% POL foam is safe and effective. Lesions with up to 50% anechoic areas had better resolution, without correlation with patient satisfaction.