Percutaneous Cryoablation of Symptomatic Intramuscular Venous Malformation

Carabin, Jonathan; Bouhamama, Amine; Vaz, Gualter; Cuinet, M.; Ricoeur, Alexis; Thibaut, Antoine; Beji, H.; Mastier, Charles; Pilleul, F.

doi:10.1016/j.jvir.2019.10.024

Cited by 13 publications

(7 citation statements)

References 26 publications

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“…The management of intramuscular hemangioma depends on the tumor location, size, extent, behavior, accessibility, resectability, and cosmetic indications [ 10 , 27 ]. Depending on the size, the management differ in terms of conservative treatment modalities (spontaneous regression [ 28 ], interferon-alpha [ 29 ], imiquimod [ 30 ], cyclophosphamide [ 31 ], and vincristine [ 32 ]), minimally invasive methods (radioisotope agents such as strontium-90 [ 33 ], sclerotherapy [ 34 ], cryotherapy [ 35 ], radiation therapy [ 36 ], carbon dioxide snow [ 37 ], argon laser [ 38 ], and Nd:YAG laser [ 39 ]), surgical options (ligation of feeding vessels [ 7 ] and excision biopsy in toto [ 2 ]), and combination therapy [ 40 , 41 , 42 , 43 , 44 , 45 ]. We instituted excision biopsy in toto to provide a better functional outcome.…”

Section: Discussionmentioning

confidence: 99%

Hemangioma of First Extensor Compartment of the Wrist– A Rare Case Report

Ranjan¹,

Kumar²,

Jeyaraman³

et al. 2021

JOCR

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Introduction: Although upper extremity intramuscular hemangioma is a rare clinical entity, it poses considerable morbidity in the functional needs of an individual. The diagnosis of intramuscular hemangioma poses a diagnostic glitch. The combined radiological and histopathological assessment provides a complete understanding and diagnosis for the same. Every tumor follows an individualized protocol for its management. Case Report: A 15-year-old female presented with swelling over dorsal aspect of distal 1/3rd right forearm, which was 3 cm away from the articular surface of the right wrist from the past 5 years. There was no history of trauma or infection over the right wrist. Finkelstein’s test was negative, which rule out de Quervain’s tenosynovitis. The movements of the right wrist were unrestricted without any distal neurovascular deficit. MRI of her right wrist and hand suggested the presence of low flow vascular malformation within the musculotendinous junction of APL and EPB muscles. The patient underwent excision biopsy of the hemangiomatous lesion in toto without any neurological complications. No recurrence was noted in the follow-up period for 6 months. Conclusion: Being a benign vascular tumor, MRI provides the gateway to diagnose intramuscular hemangioma for early intervention to provide better functional results. The choice of definitive treatment for APL and EPB hemangioma was excision biopsy in toto which provided better functional results in our patient. Keywords: Hemangioma, intramuscular, abductor pollicis longus, extensor pollicis brevis, MRI, excision biopsy.

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Section: Discussionmentioning

confidence: 99%

Hemangioma of First Extensor Compartment of the Wrist– A Rare Case Report

Ranjan¹,

Kumar²,

Jeyaraman³

et al. 2021

JOCR

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“…Adjunct techniques such as physiologic nerve monitoring for motor evoked potentials, temperature monitoring by thermocouple, or warm saline or CO 2 fluid dissection may be useful. [47][48][49] Due to pain caused by myositis, patients undergoing cryoablation of intramuscular extremity lesions may benefit from a nerve block for 1 to 2 days after the procedure.…”

Section: Cryoablationmentioning

confidence: 99%

Management of Venous Malformations

Acord

Srinivasan

2021

Semin intervent Radiol

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Venous malformations (VMs) are slow-flow, congenital vascular anomalies that are a result of vascular dysgenesis. Clinical presentation and morbidity depend on size, location, and association with other syndromes. VMs are the most common symptomatic vascular anomaly referred for intervention, usually due to thrombosis, swelling, mass effect, functional compromise, or cosmetic concerns. Treatment for larger lesions can be challenging and a multidisciplinary approach involving medical, interventional, and surgical input is critical for comprehensive care. This article will assist the interventional radiologist in patient assessment and will discuss current techniques for treatment, means to minimize adverse events, and expected outcomes.

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“…Venous malformations (VMs) are vascular developmental abnormalities that arise during fetal life and are associated with pain, movement disorders, and other symptoms [1][2][3]. A study conducted by the Ministry of Health, Labor and Welfare in Japan (Project on Intractable Hemangioma, Vascular Malformation, Lymphangioma, Lymphangiomatosis and Related Diseases in Fiscal 2014) estimated that 20,000 individuals are affected by VMs, with half of them harboring difficult-to-resect lesions due to extensive involvement or muscle infiltration [4,5].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of ethanolamine oleate in sclerotherapy in patients with difficult-to-resect venous malformations: A multicenter, open-label, single-arm study

Ozaki,

Nomura,

Osuga

et al. 2024

Preprint

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Objective To evaluate the efficacy and safety of sclerotherapy in patients with difficult-to-resect venous malformations treated with ethanolamine oleate. Design and setting This investigator-initiated clinical trial employed a multicenter, single-arm, open-label design and was conducted in Japan. Patients Overall, 44 patients with difficult-to-resect venous malformations were categorized into two cohorts: 22 patients with cystic-type malformations and 22 patients with diffuse-type malformations. Interventions Patients received injections of 5% ethanolamine oleate solution, double diluted with contrast or normal saline, with a maximum dose of 0.4 mL/kg. The same method of administration was used for children (<15 years old). The maximum volume of the prepared solution in one treatment was 30 mL. Evaluation methods Treatment efficacy was assessed by evaluating changes in lesion volume using magnetic resonance imaging and changes in pain using a visual analog scale. Results Among the 45 patients who consented, one was excluded owing to potential intracranial involvement of venous malformations during screening. Regarding the primary outcome, 26 of 44 patients (59.1%, 95% confidence interval: 44.41-72.31%) achieved ≥ 20% reduction in malformation volume, with 16 patients having cystic lesions (72.7%, 51.85-86.85%) and 10 patients having diffuse lesions (45.5%, 26.92-65.34%). Both cohorts showed significant improvement in self-reported pain scores associated with lesions 3 months post-sclerotherapy. No death or serious adverse events occurred. Hemoglobinuria was observed in 23 patients (52%), a known drug related adverse event. Prompt initiation of haptoglobin therapy led to full recovery within a month for these patients. Conclusions Ethanolamine oleate shows potential as a therapeutic sclerosing agent for patients with difficult-to-resect venous malformations.

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Percutaneous Cryoablation of Symptomatic Intramuscular Venous Malformation

Cited by 13 publications

References 26 publications

Hemangioma of First Extensor Compartment of the Wrist– A Rare Case Report

Hemangioma of First Extensor Compartment of the Wrist– A Rare Case Report

Management of Venous Malformations

Efficacy and safety of ethanolamine oleate in sclerotherapy in patients with difficult-to-resect venous malformations: A multicenter, open-label, single-arm study

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