Quality of life and clinical results after endovascular sclerotherapy: A comparison between intra- and extramuscular low-flow venous malformations

Abstract

Background Based on clinical observations we hypothesized that patients with intramuscular venous malformations (VMs) did worse or needed more sclerotherapy sessions than patients with extramuscular VMs. Purpose To evaluate the difference in treatment and quality of life (QOL) results after Polidocanol sclerotherapy of intra- and extramuscular low-flow VMs. Material and methods Forty-one patients with a VM were treated with Polidocanol in two university hospitals. The results were retrospectively analyzed. Pre- and post-treatment magnetic resonance imaging (MRI) scans were compared. All patients completed a self-evaluating form on symptoms as well as a QOL questionnaire. The results were compared between two groups: intra- and extramuscular VM’s. Results No statistically significant differences between intra- and extramuscular groups concerning QOL and specific dimensions pain, functional problems or cosmetic appearance were found. Radiological changes in MRI examinations did not correlate with any of the subjective symptoms. 56% of the patients benefitted from the treatment according to patient self-evaluation. Conclusion In this material intramuscular VM’s responded to the treatment comparably to extramuscular malformations. Post-treatment MRI findings do not correlate with subjective symptoms or QOL results and thus, a routine post-treatment examination seems to be unwarranted. Subjective symptoms and QOL results are the most important parameters in evaluating the effectiveness of sclerotherapy.

Clinical results of polidocanol sclerotherapy in venous malformation treatment: Patient-perceived improvement and satisfaction

“…17 Several publications report there is a discrepancy between radiologic and clinical outcomes after VM sclerotherapy. 7,[11][12][13]18 Bianchini, G et al reported significant improvement in the symptoms in intramuscular VMs with sclerotherapy even when 83.9% of the posttreatment MRI showed no significant change of the VMs. 11 Cure is rarely possible in VM treatment and the main concept in VM treatment is palliation of the patient's symptoms.…”

“…1,3 Clinical and radiological responses do not always correlate in VMs treatment, symptomatic relief can be achieved even when there is no improvement in the imaging findings. [11][12][13] Hence, improvement in clinical symptoms reported by the patients has a crucial role in the assessment of treatment response. 12 This study aimed to evaluate the clinical results of polidocanol sclerotherapy regarding patient perceived improvement and patient satisfaction after treatment.…”

“…[11][12][13] Hence, improvement in clinical symptoms reported by the patients has a crucial role in the assessment of treatment response. 12 This study aimed to evaluate the clinical results of polidocanol sclerotherapy regarding patient perceived improvement and patient satisfaction after treatment. Potential predictors of patient satisfaction and level of satisfaction were sought.…”

“…11–13 Hence, improvement in clinical symptoms reported by the patients has a crucial role in the assessment of treatment response. 12…”

An overview of interventional radiology techniques for the diagnosis and management of vascular anomalies: Part 1

“…Additionally, in another study of 41 patients who underwent sclerotherapy of VMs with polidocanol, there was no statistically significant difference in quality of life, pain, or functional limitations between those with intramuscular lesions versus those with extramuscular lesions. 26 For LMs, a review of several studies found that sclerotherapy alone is highly effective in the treatment of macrocystic lesions, while surgery, with or without combination sclerotherapy, is more effective in the treatment of microcystic and mixed lesions.…”