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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 3/2018

01-03-2018 | Technical Note

CT-Guided Percutaneous Sclerotherapy for Low-Flow Retrobulbar Intraconal Venous Malformations

Authors: Biao Yang, Jian Zhao, Ling Gao, Chun-Lin Li, Xing-Rong Liu, He Jiao, Zheng-Yin Liao, Cheng Yi

Published in: CardioVascular and Interventional Radiology | Issue 3/2018

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Abstract

Background and Aims

Until now, no study has focused exclusively on low-flow retrobulbar intraconal venous malformations (RIVMs) which may require treatment due to cosmetic defect, pain, and visual dysfunction. The treatment for RIVMs which surround the optic nerve remains challenging. This case series aimed to evaluate the technical feasibility, effectiveness, and safety of percutaneous sclerotherapy with polidocanol for low-flow RIVMs, using local anesthesia.

Method

This is a prospective, non-comparative, single-center, interventional case series. All patients signed informed consent forms. Seven patients with RIVMs were treated with percutaneous sclerotherapy with polidocanol/air foam using CT guidance. Primary endpoints are reduction in the volume of RIVMs and pain relief assessed by visual analog scale (VAS). Secondary endpoints are exophthalmos and recording adverse events obtained in clinical follow-up during outpatient visits.

Results

Results revealed that the mean volume of RIVMs was decreased from 12.05 ± 6.35 cm3 preoperatively to 1.56 ± 0.43 cm3 postoperatively, (p = 0.005), with a mean decrease of 87.05%. The intraocular pressure was decreased from 14.19 ± 2.99 to 11.79 ± 1.25 mmHg, (p = 0.043). The mean VAS score was decreased from 3.43 ± 2.37 preoperatively to 1.29 ± 0.76 postoperatively, (p = 0.023). The exophthalmos score was decreased from 1.75 ± 0.27 to 1.34 ± 0.31 cm, (p = 0.005). All patients were satisfied with the treatment, which did not leave a postoperative scar.

Conclusions

The results of percutaneous intralesion injection of polidocanol for RIVMs are encouraging. The present results suggest that this method could be a safe and effective treatment option for patients with RIVMs.
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Literature
1.
Garza G, Fay A, Rubin PA. Treatment of pediatric vascular lesions of the eyelid and orbit. Int Ophthalmol Clin. 2001;41(4):43–55.CrossRefPubMed
2.
Buckmiller LM, Richter GT, Suen JY. Diagnosis and management of hemangiomas and vascular malformations of the head and neck. Oral Dis. 2010;16(5):405–18.CrossRefPubMed
3.
Jia R, Xu S, Huang X, et al. Pingyangmycin as first-line treatment for low-flow orbital or periorbital venous malformations: evaluation of 33 consecutive patients. JAMA Ophthalmol. 2014;132(8):942–8.CrossRefPubMed
4.
Rootman J, Heran MK, Graeb DA. Vascular malformations of the orbit: classification and the role of imaging in diagnosis and treatment strategies. Ophthalmic Plast Reconstr Surg. 2014;30(2):91–104.CrossRef
5.
Lee CH, Chen SG. Direct percutaneous ethanol instillation for treatment of venous malformation in the face and neck. Br J Plast Surg. 2005;58(8):1073–8.CrossRefPubMed
6.
Harmoush S, Chinnadurai P, El Salek K, et al. Multimodality image-guided sclerotherapy of low-flow orbital vascular malformations: report of single-center experience. J Vasc Interv Radiol. 2016;27(7):987–95.CrossRefPubMed
7.
Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL. Cirse quality assurance document and standards for classification of complications: The Cirse classification system. Cardiovasc Interv Radiol. 2017;40(8):1141–6.CrossRef
8.
Pimpalwar S, Chinnadurai P, Marx DP. Low-flow vascular malformations of the orbit: evaluation and management. In: Yen M, editor. Vascular Lesions of the Orbit and Face. Cham: Springer; 2016. p. 89–99.CrossRef
9.
Tansatit T, Apinuntrum P, Phetudom T. A cadaveric feasibility study of the intraorbital cannula injections of hyaluronidase for initial salvation of the ophthalmic artery occlusion. Aesthet Plast Surg. 2015;39(2):252–61.CrossRef
10.
Eivazi B, Wiegand S, Negm H, et al. Orbital and periorbital vascular anomalies–an approach to diagnosis and therapeutic concepts. Acta Oto Laryngol. 2010;130(8):942–51.CrossRef
11.
Lacey B, Rootman J, Marotta TR. Distensible venous malformations of the orbit: clinical and hemodynamic features and a new technique of management. Ophthalmology. 1999;106(6):1197–209.CrossRefPubMed
12.
Schwarcz RM, Ben Simon GJ, Cook T, Goldberg RA. Sclerosing therapy as first line treatment for low flow vascular lesions of the orbit. Am J Ophthalmol. 2006;141(2):333–9.CrossRefPubMed
13.
Chen Y, Li Y, Zhu Q, et al. Fluoroscopic intralesional injection with pingyangmycin lipiodol emulsion for the treatment of orbital venous malformations. Am J Roentgenol. 2008;190(4):966–71.CrossRef
14.
Nesbit GM, Nesbit EG, Hamilton BE. Integrated cone-beam CT and fluoroscopic navigation in treatment of head and neck vascular malformations and tumors. J Neurointerv Surg. 2011;3(2):186–90.CrossRefPubMed
15.
Neumann D, Isenberg SJ, Rosenbaum AL, Goldberg RA, Jotterand VH. Ultrasonographically guided injection of corticosteroids for the treatment of retroseptal capillary hemangiomas in infants. J AAPOS. 1997;1(1):34–40.CrossRefPubMed
16.
Chiramel GK, Keshava SN, Moses V, Mammen S, David S, Sen S. Percutaneous sclerotherapy of congenital slow-flow vascular malformations of the orbit. Cardiovasc Interv Radiol. 2015;38(2):270–9.CrossRef
Metadata
Title
CT-Guided Percutaneous Sclerotherapy for Low-Flow Retrobulbar Intraconal Venous Malformations
Authors
Biao Yang
Jian Zhao
Ling Gao
Chun-Lin Li
Xing-Rong Liu
He Jiao
Zheng-Yin Liao
Cheng Yi
Publication date
01-03-2018
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 3/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-017-1822-y

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