Prospective randomized efficacy of ultrasound-guided foam sclerotherapy compared with ultrasound-guided liquid sclerotherapy in the treatment of symptomatic venous malformations

Yamaki, Takashi; Nozaki, Motohiro; Sakurai, Hisanao; Takeuchi, Masaki; Soejima, Kazutaka; Kono, Taro

doi:10.1016/j.jvs.2007.11.026

Cited by 148 publications

(109 citation statements)

References 21 publications

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“…Efficacy of foam sclerotherapy (FS) and liquid sclerotherapy (LS) has been investigated in a comparative non-RCT conducted by Yamaki et al 30 Under ultrasound guidance, 62 patients were injected with either foam or liquid to treat GSV incompetence. Occlusion of saphenous incompetence was achieved in 68% of foam-treated patients and 17.5% of liquid-treated patients after 12 months.…”

Section: Clinical Resultsmentioning

confidence: 99%

Endovenous Management of Varicose Veins

et al. 2018

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Abstract:Varicose veins are a very common condition and have been the subject of a recent proliferation of treatment modalities. The advent of the endovenous treatment era has led to a confusing array of different techniques which can be daunting when making the transition from traditional surgery. All modalities offer excellent results in the right situation and each has their own treatment profile. Thermal ablation techniques have matured and have a reassuring and reliable outcome, but the arrival of non-thermal techniques has delivered further options for both patient and surgeon. This article provides an overview of the different treatment devices and modalities available to the modern superficial vein surgeon and details the currently available evidence and summation analysis to help surgeons to make an appropriate treatment choice for their patients. Keywords:Endovenous ablation, varicose veins, venous disease, radiofrequency, sclerotherapy, cyanoacrylate Page 1 of 24 http://mc.manuscriptcentral.com/ang Angiology 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 IntroductionVaricose veins are a common condition affecting up to one-third of the population, with detrimental effects on the quality of life (QoL). 1-2Until the past decade, the traditional technique of saphenofemoral or saphenopopliteal ligation with or without vein stripping has been the gold standard treatment of truncal saphenous incompetence. This usually necessitates either general or regional anaesthesia. 3 Although surgery provides good outcomes, it is associated with ecchymosis, hematoma, tenderness, 4 infection, nerve injury, delayed return to normal activity 3-5 and routinely necessitates narcotic analgesia. 3In response to the need for less invasive treatment, endovenous treatments, namely radio-frequency ablation (RFA) and endovenous laser ablation (EVLA) have been developed. These have led to a reduction in morbidity compared with open surgery, 4-6 by reducing postoperative pain, providing faster recovery time, improving QoL and lowering complication rates. 7-8More recently, new non-thermal, non-tumescent (NTNTs) treatments have been developed to overcome the shortcomings associated with thermal ablation. Both thermal and non-thermal treatments are discussed in this review. Thermal-Tumescent Ablative ManagementSince 1999, endovenous thermal ablation, in the form of RFA and EVLA have been developed. More recently, endovenous microwave ablation (EMA) and steam vein sclerosis (SVS) have also been introduced. Their mechanism of action involves using heat to cause thermal damage to the venous wall. Radio-frequency ablation (RFA)The practice of RFA utilizes radio-frequency waves to produce thermal energy (85-120°C) resulting in endothelial damage and sealing of the incompetent vein ( Figure 1). In 1999, the U.S. Food and Drug Administration (FDA) approved RFA for...

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Section: Clinical Resultsmentioning

confidence: 99%

Endovenous Management of Varicose Veins

et al. 2018

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“…In previous studies, STS has been associated with success rates of 43-84%, 52,[54][55][56] whereas polidocanol has similarly reported ranges of 45-84%. 57,58 Importantly, the definition of an adequate response as well as the lesion size, anatomical location and patient population is highly variable among previous studies, and, thus, it is difficult to ascertain the true efficacy of STS and polidocanol for VM treatment.…”

Section: Capillary Malformationsmentioning

confidence: 99%

“…However, the majority of complications with both STS and polidocanol are minor, with pain at the injection site and local skin necrosis being the most common 53,63,64 and likely related to tissue extravasation with damage of adjacent vessels at the injection site. 64,65 A recent study has shown greater efficacy with foamed vs liquid injection of polidocanol, 57 and new guidelines suggest both polidocanol and STS should be administered in foam form. 66 The use of foam instead of liquid allows greater volume coverage and increased surface area contact with the vessel endothelium, while also slowing flow through the lesion to maximize contact with the vessel.…”

Section: Capillary Malformationsmentioning

confidence: 99%

Vascular anomalies: classification, imaging characteristics and implications for interventional radiology treatment approaches

Mulligan

Prajapati²,

Martin

et al. 2014

BJR

168

132

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The term vascular anomaly represents a broad spectrum of vascular pathology, including proliferating vascular tumours and vascular malformations. While the treatment of most vascular anomalies is multifactorial, interventional radiology procedures, including embolic therapy, sclerotherapy and laser coagulation among others, are playing an increasingly important role in vascular anomaly management. This review discusses the diagnosis and treatment of common vascular malformations, with emphasis on the technique, efficacy and complications of different interventional radiology procedures.

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“…It has been faced with problems including dispersion of drug into surrounding tissue with significantly reduced therapeutic effect, or invasion of important tissues adjacent to the lesion such as nerves, salivary glands or vessels, which can lead to serious complications. Ultrasound guidance was first used by Yamaki (32)with VMs in the cervical-facial region by intralesional injection of absolute alcohol, and he researched this method in detail with reported advantages like prevention of intra-arterial injections (34,35).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided Intralesional Bleomycin Injection (IBI) for Treatment of Cutaneous Hemangiomas and Vascular Malformations

Memon

Malik

Anjum

et al. 2016

JGR

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Purpose: To report the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin in the treatment of cutaneous hemangiomas and vascular malformations. Material & Methods:The medical records of patients with cutaneous hemangiomas and vascular malformations treated with the intralesional injection of bleomycin under ultrasound guidance between August 2009 and June 2013 at the Indus Hospital, Karachi were reviewed retrospectively using a computerized medical record information management system. Data were extracted using a pre-coded performa that included patient demographics, type and location of lesion, number of treatments, presenting/pre-and post-treatment clinical symptoms (pain, swelling, heaviness, size, discoloration), ultrasound appearance and vascularity, and post-treatment side effects. The dose range of bleomycin was 0.5-1.0 mg/kg, but not exceeding 15 mg in a single session. A maximum of four treatments were given in any given patient except for one, who presented with recurrence after a year of complete resolution. Therapeutic outcome was determined using review of ultrasound images and recorded clinical assessment. Treatment response was categorized as: (i) complete resolution [more than 90% reduction]; (ii) substantial reduction [more than 50% reduction]; (iii) mild reduction [25% reduction]; or, (iv) no improvement [<10% reduction].Results: A total of 30 patients (16 female, 14 male), ranging in age from 8 months to 48 years (mean age 10.2 years), were treated from 2009 to 2013. There were 23 hemangiomas. Seven were vascular malformations, of which five were lymphatic malformations and two were venous malformations. Twenty-eight lesions were located in the head and neck region, and two were peripheral. In 24 of the 30 patients (76%), treatment had been completed. In six patients (21%) treatment was ongoing at the time of this report. Seventeen of the 23 hemangiomas (74%) were completely resolved clinically and on ultrasound, five (22%) showed substantial improvement and one (4%) showed mild improvement. In five of the seven vascular malformations (71%) lymphatic malformations resolved completely, and two (29%) venous malformations showed substantial improvement. Of the 13 patients presenting with discoloration, there was complete resolution in one (7.7%), marked reduction in 11 (84.6%) and mild reduction in one (7.7%). Of seven patients presenting with pain, there was complete resolution in two (28.6%), marked reduction in two (28.6%), mild reduction in two (28.6%), and no improvement in one (14.3%). There were no pulmonary complications. Conclusion:Ultrasound-guided intralesional injection of bleomycin is an option to consider for the treatment of certain types of cutaneous hemangiomas and vascular malformations. Prospective studies should be undertaken to understand the various factors contributing to therapeutic success. Ultrasound-guided Intralesional Bleomycin Injection (IBI) for Treatment of Cutaneous Hemangiomas and Vascular Malformations

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Prospective randomized efficacy of ultrasound-guided foam sclerotherapy compared with ultrasound-guided liquid sclerotherapy in the treatment of symptomatic venous malformations

Abstract: These findings suggest that UGFS could have greater promise compared with UGLS in the treatment of VMs.

Cited by 148 publications

References 21 publications

Endovenous Management of Varicose Veins

Endovenous Management of Varicose Veins

Vascular anomalies: classification, imaging characteristics and implications for interventional radiology treatment approaches

Ultrasound-guided Intralesional Bleomycin Injection (IBI) for Treatment of Cutaneous Hemangiomas and Vascular Malformations

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