Ethanol sclerotherapy for venous malformation

Steiner, Frederica; FitzJohn, Trevor; Tan, Swee T.

doi:10.1111/ans.12833

Cited by 33 publications

(25 citation statements)

References 30 publications

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“…Management of VM is generally unsatisfactory especially for extensive lesions and includes observation, elastic support ( 7 ), low-dose aspirin ( 7 ), sclerotherapy, such as ethanol sclerotherapy ( 8 , 9 ), surgery, or a combination of these treatments ( 10 – 12 ).…”

Section: Introductionmentioning

confidence: 99%

Embryonic Stem Cell-Like Subpopulations in Venous Malformation

et al. 2017

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BackgroundVenous malformation (VM) consists of a network of ectatic anomalous thin-walled venous channels. A role for an activating TIE2 mutation in the development of the dilated luminal vessels in VM, and its proposed involvement of embryonic stem cells (ESCs), led us to investigate the expression of ESC markers in subcutaneous VM (SCVM) and intramuscular VM (IMVM).MethodsFormalin-fixed paraffin-embedded sections of SCVM from seven patients and IMVM samples from seven patients were analyzed for the expression of Nanog, pSTAT3, OCT4, SOX2, SALL4, and CD44, using 3,3′-diaminobenzidine (DAB) immunohistochemical (IHC) staining. All these samples did not express lymphatic marker D2-40. NanoString mRNA analysis and RT-PCR were performed on snap-frozen samples of SCVM (n = 3) and IMVM (n = 3) from the respective original cohorts of patients included in DAB IHC staining. To confirm co-expression of two proteins, immunofluorescent (IF) IHC staining on two representative samples of IMVM and SCVM samples from the original cohorts of patients included for DAB IHC staining was performed.ResultsDAB IHC staining demonstrated expression of all of the above ESC markers in both SCVM and IMVM samples. IF IHC staining showed that these markers were localized to the endothelium within these lesions and that Nanog, pSTAT3, SOX2, and CD44 were also expressed by cells outside of the endothelium. NanoString mRNA analysis confirmed transcription activation of pSTAT3, OCT4, and CD44. RT-qPCR confirmed transcription activation of Nanog, SOX2, and SALL4.ConclusionOur findings support the presence of two ESC-like subpopulations, one within and one outside of the endothelium, of both SCVM and IMVM. Given that the endothelial ESC-like subpopulation expresses the more primitive marker, OCT4, it is exciting to speculate that they give rise to the non-endothelial subpopulation.

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Section: Introductionmentioning

confidence: 99%

Embryonic Stem Cell-Like Subpopulations in Venous Malformation

et al. 2017

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“…One patient developed reduced infraorbital sensation, and another patient developed skin necrosis requiring surgical debridement and direct closure. This was part of the major complications that occurred in 5.6% of patients in a series of 56 patients with VM treated with ES we have reported previously (27). …”

Section: Discussionmentioning

confidence: 72%

“…The residual VM over the lateral canthus was debulked and remained unchanged over 2 years (D) . Reproduced with permission from the Australian and New Zealand Journal of Surgery (27). …”

Section: Resultsmentioning

confidence: 99%

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Management of Orbital and Periorbital Venous Malformation

et al. 2017

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BackgroundTo review our management of common venous malformation (VM) affecting the orbit and/or periorbital area.MethodsConsecutive patients with orbital and/or periorbital VM were identified from our vascular anomalies database. Demographic details of the patients, anatomic site(s) affected, symptoms and signs, presence of a family history of VM, and types of treatment(s) were collected, supplemented by chart review.ResultsA total of 24 patients’ age 1–68 (mean, 30) years with orbital and/or periorbital VM presented with cosmetic concerns (n = 17, 71%), distensibility (n = 15, 63%), pain (n = 9, 38%), diplopia (n = 4, 17%), and spontaneous thrombosis (n = 1, 8%). The VM caused globe dystopia (n = 13, 54%), enophthalmos (n = 6, 25%), proptosis (n = 3, 12%), exotropia (n = 3, 12%), and pseudoptosis with visual obstruction (n = 3, 13%). A total of 11 (46%) patients were managed conservatively. 13 (54%) patients underwent active treatment. Ethanol sclerotherapy (ES) was performed in six patients with extensive facial VM associated with orbital/periorbital involvement, resulting in symptomatic improvement in five patients, one of whom developed skin necrosis and another patient developed reduced infraorbital nerve sensation. Surgery was performed for localized lesion (n = 3, 23%), for extensive lesions (n = 4, 31%) and as an adjunct to ES (n = 6, 46%) resulting in symptomatic improvement in all patients. One patient required correction of lower lid ectropion.ConclusionOrbital and/or periorbital VMs are heterogeneous, and management needs to be individualized. Surgery is used for localized lesions aiming for complete excision, as a debulking procedure for extensive orbital/periorbital VM when ES was not possible, or following ES for extensive facial VM with orbital and/or periorbital involvement.

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“…This prevents blood from diluting the drug, enlarges the contact area with the vascular endothelium, prolongs contact time and improves hardening efficiency (27). Moreover, the curative effect was clear, with reduced treatment numbers, thereby effectively reducing the risk of adverse reactions (28)(29)(30). In the present study, 19 lesions were treated with a pingyangmycin and dexamethasone combination.…”

Section: Discussionmentioning

confidence: 73%

DSA‑guided percutaneous sclerotherapy for children with oropharyngeal low‑flow venous malformation

Song

Guo²,

Sheng

et al. 2020

Exp Ther Med

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The present study investigated the efficacy and safety of digital subtraction angiography-guided 3% polidocanol foam sclerosing agent, as well as the combination of pingyangmycin and dexamethasone, for the treatment of children with oropharyngeal low-flow venous malformation. A total of 27 children with 35 lesions with oropharyngeal low-flow venous malformation were included. The subjects were randomly divided into Groups A (13 patients with 16 lesions, treated with 3% polidocanol foam sclerosing agent) and B (14 patients with 19 lesions, treated with pingyangmycin + dexamethasone), respectively. The clinical efficacies and adverse reactions were analyzed and compared between these two groups. The average number of treatment times for Group A was 2.45±0.6, with an efficacy rate of 87.50%, while the average number of treatment times for Group B was 2.07±0.4, with an efficacy rate of 84.21%. No significant difference was found in the average treatment times or efficacy rates between Groups A and B. In addition, the adverse reaction incidence for Groups A and B were 38.46 and 14.29%, respectively, with statistically significant differences between these two groups. The combination of pingyangmycin and dexamethasone was safe and effective in treating children with oropharyngeal low-flow venous malformation, with fewer adverse reactions and is worthy of clinical promotion.

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Ethanol sclerotherapy for venous malformation

Abstract: ES reduces pain, contour deformity and skin discoloration, and improves appearance, function and QoL. Our complication rates are consistent with the literature.

Cited by 33 publications

References 30 publications

Embryonic Stem Cell-Like Subpopulations in Venous Malformation

Embryonic Stem Cell-Like Subpopulations in Venous Malformation

Management of Orbital and Periorbital Venous Malformation

DSA‑guided percutaneous sclerotherapy for children with oropharyngeal low‑flow venous malformation

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