Presentation on theme: "Foam sclerotherapy in treatment of venous malformations"— Presentation transcript:
1 Foam sclerotherapy in treatment of venous malformations Michał KowalczykTutor: Assoc. Prof. Przemysław Przewratil MD, PhDFoam sclerotherapy in treatment of venous malformationsin children.Department of Pediatric Surgery and Oncology Laboratory for Vascular Anomalies Medical University of Lodz
2 Venous malformation (VM) ISSVA ClassificationInternational Society for the Study of Vascular AnomaliesV A S C U L A R A N O M A L I E STUMORSMALFORMATIONSInfantile haemangiomaLow-flowFast-FlowVenous malformation (VM)Arterial malformation (AM)Capillary malformation (CM)Arteriovenous fistula (AVF)Lymphatic malformation (LM)Arteriovenous malformation (AVM)
3 Venous malformation lesion composed of abnormal collections of veins mostly localized in the skincan affect any other tissue or organcutaneous and subcutaneous tissuemusclesjointsintestinesmost frequent low-flow vascular malformationsmay cause cosmetic or functional defects as well asphysical disability
5 Dubois and Puig Classification Orthop Clin N Am 2006, 37,
6 Foam sclerotherapyA percutaneous injection of a sclerosing substance directly into a lesion.Prior to injection the sclerosing agent is mixed with air to make a foam.Sclerosant agent causes obliterationof the vessel, what effects in sealing off the blood flow.It may be administered as an only procedure or in combination with surgical resection.Multiple sessions are often required to achieve visual improvement or permanent results.
7 Aim of a studyAnalysis of the results of the treatment of venous malformations using foam sclerotherapy.
8 Material & Methods Retrospective analysis Foam sclerotherapy 34 patients treated between June 2006 and December 201120 female (59%), 14 male (41%)Age range: 1-15 (average 7 years)Foam sclerotherapyPolidocanol (Aethoxysclerol) 1% / 3% | 1 – 6mlAssessment by US, MRIPhlebographyPerformed prior to the sclerotherapy in 19 patients (56%)Surgical resectionPreceded by sclerotherapy - 6 patients (18%)Duration of hospital stay – ranged from 1 to 5 days (average 2,5)
19 Results Temporary side effects were observed in 2 (6%) patients. Vasculitis – 1 caseSkin necrosis – 1 caseInitial phlebography increased significantly the effectiveness and safety of each sclerotherapy.In 6 patients (18%) sclerotherapy preceded the surgical resection improving their performance.Adopted method was rated by parents and patients as effective and hardly invasive.
20 ConclusionsVMs treatment is based on a proper diagnosis according to ISSVA classification, differentiating them from infantile hemangiomas.Sclerotherapy with polidaconol used as foam is effective and safe managment of VMs.