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Published in: European Radiology 10/2009

01-10-2009 | Interventional

Polidocanol sclerotherapy for painful venous malformations: evaluation of safety and efficacy in pain relief

Authors: Hidefumi Mimura, Hiroyasu Fujiwara, Takao Hiraki, Hideo Gobara, Takashi Mukai, Tsuyoshi Hyodo, Toshihiro Iguchi, Kotaro Yasui, Yoshihiro Kimata, Susumu Kanazawa

Published in: European Radiology | Issue 10/2009

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Abstract

The aim of this study was to retrospectively evaluate the safety and efficacy of polidocanol sclerotherapy in pain relief for painful venous malformations (VMs). Thirty-one patients with painful VMs underwent polidocanol sclerotherapy. Pain intensity was assessed with an 11-point verbal numerical rating scale. Sclerotherapy was technically successful in 58 (98.3%) of 59 sessions. Twenty-six (89.7%) out of 29 patients experienced an improvement in pain after sclerotherapy at follow-up, a mean of 46 months after treatment. The mean pain score improved from 6.6 ± 2.5 before treatment to 2.4 ± 2.9 after treatment (P <.001). The factors that significantly influenced the therapeutic effect were size of lesion (P = .008), margin of lesion (P = .006), and stasis of sclerosant (P = .032). Adverse events included hypotension and bradycardia during the procedure. No major complication occurred. Polidocanol sclerotherapy is safe and most efficacious in providing pain relief for patients with small VMs (equal to or less than 10 cm in diameter), VMs with a well-defined margin, and VMs with good stasis of sclerosant during sclerotherapy.
Literature
1.
go back to reference Yakes WF, Luethke JM, Parker SH et al (1990) Ethanol embolization of vascular malformations. Radiographics 10:787–796PubMed Yakes WF, Luethke JM, Parker SH et al (1990) Ethanol embolization of vascular malformations. Radiographics 10:787–796PubMed
2.
go back to reference Yakes WF (1994) Extremity venous malformations diagnosis and management. Seminars in interventional radiology 11:332–339CrossRef Yakes WF (1994) Extremity venous malformations diagnosis and management. Seminars in interventional radiology 11:332–339CrossRef
3.
go back to reference Shireman PK, McCarthy WJ, Yao JS et al (1997) Treatment of venous malformations by direct injection with ethanol. J Vasc Surg 26:838–844PubMedCrossRef Shireman PK, McCarthy WJ, Yao JS et al (1997) Treatment of venous malformations by direct injection with ethanol. J Vasc Surg 26:838–844PubMedCrossRef
4.
go back to reference Donnelly LF, Bissett GS 3rd, Adams DM (1999) Combined sonographic and fluoroscopic guidance: a modified technique for percutaneous sclerosis of low-flow vascular malformations. Am J Roentgenol 173:655–657 Donnelly LF, Bissett GS 3rd, Adams DM (1999) Combined sonographic and fluoroscopic guidance: a modified technique for percutaneous sclerosis of low-flow vascular malformations. Am J Roentgenol 173:655–657
5.
go back to reference Burrows PE, Mason KP (2004) Percutaneous treatment of low flow vascular malformations. J Vasc Interv Radiol 15:431–445PubMed Burrows PE, Mason KP (2004) Percutaneous treatment of low flow vascular malformations. J Vasc Interv Radiol 15:431–445PubMed
6.
go back to reference Berenguer B, Burrows PE, Zurakowski D et al (1999) Sclerotherapy of craniofacial venous malformations: complications and results. Plast Reconstr Surg 104:1–11PubMedCrossRef Berenguer B, Burrows PE, Zurakowski D et al (1999) Sclerotherapy of craniofacial venous malformations: complications and results. Plast Reconstr Surg 104:1–11PubMedCrossRef
7.
go back to reference Lee BB, Do YS, Byun HS et al (2003) Advanced management of venous malformation with ethanol sclerotherapy: mid-term results. J Vasc Surg 37:533–538PubMedCrossRef Lee BB, Do YS, Byun HS et al (2003) Advanced management of venous malformation with ethanol sclerotherapy: mid-term results. J Vasc Surg 37:533–538PubMedCrossRef
8.
go back to reference Suh JS, Shin KH, Na JB et al (1997) Venous malformations: sclerotherapy with a mixture of ethanol and lipiodol. Cardiovasc Intervent Radiol 20:268–273PubMedCrossRef Suh JS, Shin KH, Na JB et al (1997) Venous malformations: sclerotherapy with a mixture of ethanol and lipiodol. Cardiovasc Intervent Radiol 20:268–273PubMedCrossRef
9.
go back to reference Goyal M, Causer PA, Armstrong D (2002) Venous vascular malformations in pediatric patients: comparison of results of alcohol sclerotherapy with proposed MR imaging classification. Radiology 223:639–644PubMedCrossRef Goyal M, Causer PA, Armstrong D (2002) Venous vascular malformations in pediatric patients: comparison of results of alcohol sclerotherapy with proposed MR imaging classification. Radiology 223:639–644PubMedCrossRef
10.
go back to reference O’Donovan JC, Donaldson JS, Morello FP et al (1997) Symptomatic hemangiomas and venous malformations in infants, children, and young adults: treatment with percutaneous injection of sodium tetradecyl sulfate. Am J Roentgenol 169:723–729 O’Donovan JC, Donaldson JS, Morello FP et al (1997) Symptomatic hemangiomas and venous malformations in infants, children, and young adults: treatment with percutaneous injection of sodium tetradecyl sulfate. Am J Roentgenol 169:723–729
11.
go back to reference Dubois JM, Sebag GH, De Prost Y et al (1991) Soft-tissue venous malformations in children: percutaneous sclerotherapy with Ethibloc. Radiology 180:195–198PubMed Dubois JM, Sebag GH, De Prost Y et al (1991) Soft-tissue venous malformations in children: percutaneous sclerotherapy with Ethibloc. Radiology 180:195–198PubMed
12.
go back to reference Riche MC, Hadjean E, Tran-Ba-Huy P et al (1983) The treatment of capillary-venous malformations using a new fibrosing agent. Plast Reconstr Surg 71:607–614PubMedCrossRef Riche MC, Hadjean E, Tran-Ba-Huy P et al (1983) The treatment of capillary-venous malformations using a new fibrosing agent. Plast Reconstr Surg 71:607–614PubMedCrossRef
13.
go back to reference Choi YH, Han MH, O-Ki K et al (2002) Craniofacial cavernous venous malformations: percutaneous sclerotherapy with use of ethanolamine oleate. J Vasc Interv Radiol. 13:475–482PubMedCrossRef Choi YH, Han MH, O-Ki K et al (2002) Craniofacial cavernous venous malformations: percutaneous sclerotherapy with use of ethanolamine oleate. J Vasc Interv Radiol. 13:475–482PubMedCrossRef
14.
go back to reference Yamaki T, Nozaki M, Sasaki K (2000) Color duplex-guided sclerotherapy for the treatment of venous malformations. Dermatol Surg 26:323–328PubMedCrossRef Yamaki T, Nozaki M, Sasaki K (2000) Color duplex-guided sclerotherapy for the treatment of venous malformations. Dermatol Surg 26:323–328PubMedCrossRef
15.
go back to reference Jain R, Bandhu S, Sawhney S et al (2002) Sonographically guided percutaneous sclerosis using 1% polidocanol in the treatment of vascular malformations. J Clin Ultrasound 30:416–423PubMedCrossRef Jain R, Bandhu S, Sawhney S et al (2002) Sonographically guided percutaneous sclerosis using 1% polidocanol in the treatment of vascular malformations. J Clin Ultrasound 30:416–423PubMedCrossRef
16.
go back to reference Cabrera J, Cabrera J Jr., Garcia-Olmedo MA et al (2003) Treatment of venous malformations with sclerosant in microfoam form. Arch Dermatol 139:1409–1416PubMedCrossRef Cabrera J, Cabrera J Jr., Garcia-Olmedo MA et al (2003) Treatment of venous malformations with sclerosant in microfoam form. Arch Dermatol 139:1409–1416PubMedCrossRef
17.
go back to reference Mol W, Furukawa H, Sasaki S et al (2007) Evaluation of the sclerotherapeutic efficacy of ethanol, polidocanol, and OK-432 using an in vitro model. Dermatol Surg 33:1452–1459PubMed Mol W, Furukawa H, Sasaki S et al (2007) Evaluation of the sclerotherapeutic efficacy of ethanol, polidocanol, and OK-432 using an in vitro model. Dermatol Surg 33:1452–1459PubMed
18.
go back to reference Meyer JS, Hoffer FA, Barnes PD et al (1991) Biological classification of soft-tissue vascular anomalies: MR correlation. Am J Roentgenol 157:559–564 Meyer JS, Hoffer FA, Barnes PD et al (1991) Biological classification of soft-tissue vascular anomalies: MR correlation. Am J Roentgenol 157:559–564
19.
go back to reference Rak KM, Yakes WF, Ray RL et al (1992) MR imaging of symptomatic peripheral vascular malformations. Am J Roentgenol 159:107–112 Rak KM, Yakes WF, Ray RL et al (1992) MR imaging of symptomatic peripheral vascular malformations. Am J Roentgenol 159:107–112
20.
go back to reference Dubois J, Soulez G, Oliva VL et al (2001) Soft-tissue venous malformations in adult patients: imaging and therapeutic issues. Radiographics 21:1519–1531PubMed Dubois J, Soulez G, Oliva VL et al (2001) Soft-tissue venous malformations in adult patients: imaging and therapeutic issues. Radiographics 21:1519–1531PubMed
21.
go back to reference Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69:412–422PubMed Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69:412–422PubMed
22.
go back to reference Enjolras O (1997) Classification and management of the various superficial vascular anomalies: hemangiomas and vascular malformations. J Dermatol 24:701–710PubMed Enjolras O (1997) Classification and management of the various superficial vascular anomalies: hemangiomas and vascular malformations. J Dermatol 24:701–710PubMed
23.
go back to reference Sacks D, McClenny TE, Cardella JF et al (2003) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202PubMed Sacks D, McClenny TE, Cardella JF et al (2003) Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202PubMed
24.
go back to reference Marrocco-Trischitta MM, Guerrini P, Abeni D et al (2002) Reversible cardiac arrest after polidocanol sclerotherapy of peripheral venous malformation. Dermatol Surg 28:153–155PubMedCrossRef Marrocco-Trischitta MM, Guerrini P, Abeni D et al (2002) Reversible cardiac arrest after polidocanol sclerotherapy of peripheral venous malformation. Dermatol Surg 28:153–155PubMedCrossRef
25.
go back to reference Feied CF, Jackson JJ, Bren TS et al (1994) Allergic reactions to polidocanol for vein sclerosis. Two case reports. J Dermatol Surg Oncol 20:466–468PubMed Feied CF, Jackson JJ, Bren TS et al (1994) Allergic reactions to polidocanol for vein sclerosis. Two case reports. J Dermatol Surg Oncol 20:466–468PubMed
Metadata
Title
Polidocanol sclerotherapy for painful venous malformations: evaluation of safety and efficacy in pain relief
Authors
Hidefumi Mimura
Hiroyasu Fujiwara
Takao Hiraki
Hideo Gobara
Takashi Mukai
Tsuyoshi Hyodo
Toshihiro Iguchi
Kotaro Yasui
Yoshihiro Kimata
Susumu Kanazawa
Publication date
01-10-2009
Publisher
Springer-Verlag
Published in
European Radiology / Issue 10/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1442-2

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