Sclerotherapy complications of peripheral venous malformations

Aronniemi, Johanna; Castrén, Eeva; Lappalainen, Kimmo; Vuola, Pia; Salminen, Päivi; Pitkäranta, Anne; Pekkola, Johanna

doi:10.1177/0268355515613740

Cited by 34 publications

(25 citation statements)

References 41 publications

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“…Major complications are reported in 10-30 % [33]. Another recent study by Aronniemi et al showed an overall complication rate per procedure of 12.5 % [34]. Common complications of sclerotherapy include nerve [24].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of procedures were carried out with the patient under general anaesthesia. If the patients were older and able to understand the procedure, local or none anaesthesia was fi rst choice in the treatment of VMs [18]. Fluid-fi lled venous spaces were cannulated with 20-gauge or 21-gauge needles under ultrasound guidance [19].…”

Section: Sclerotherapy Of Vascular Malformationsmentioning

confidence: 99%

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Percutaneous sclerotherapy for spongiform venous malformations – analysis of patient-evaluated outcome and satisfaction

Clemens

Baumann

Husmann

et al. 2017

Vasa

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Summary:Background: Congenital venous malformations are frequently treated with sclerotherapy. Primary treatment goal is to control the often size-related symptoms. Functional impairment and aesthetical aspects as well as satisfaction have rarely been evaluated. Patients and methods: Medical records of patients who underwent sclerotherapy of spongiform venous malformations were reviewed and included in this retrospective study. The outcome of sclerotherapy as self-reported by patients was assessed in a 21 item questionnaire. Results: Questionnaires were sent to 166 patients with a total of 327 procedures. Seventy-seven patients (48 %) with a total of 159 procedures (50 %) responded to the survey. Fifty-seven percent of patients were male. The age ranged from 1 to 38.1 years with a median age of 16.4 years. The lower extremities were the most common treated area. Limitations caused by the venous malformation improved in the majority of patients (e.g. pain improvement 87 %, improvement of swelling 83 %) but also worsening of symptoms occurred in a minority of cases. Seventy-seven per cent would undergo sclerotherapy again. Conclusions: Sclerotherapy for treatment of venous malformations results in signifi cant reduction of symptoms. Multiple treatments are often needed, but patients are willing to undergo them.

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Section: Discussionmentioning

confidence: 99%

Section: Sclerotherapy Of Vascular Malformationsmentioning

confidence: 99%

Percutaneous sclerotherapy for spongiform venous malformations – analysis of patient-evaluated outcome and satisfaction

Clemens

Baumann

Husmann

et al. 2017

Vasa

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“…Berenguer and colleagues reported a 50% rate of adverse reactions to sclerotherapy of craniofacial VM with anhydrous ethanol. Aronniemi and colleagues compared sclerosants in the treatment of peripheral VM and found a greater risk of local complications in subcutaneous lesions with ethanol.…”

Section: Discussionmentioning

confidence: 99%

Bleomycin‐induced flagellate erythema after venous malformation sclerosis—Case report and brief review

Pinto

Lorca-García

Berenguer

et al. 2017

Pediatric Dermatology

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Bleomycin-induced flagellate erythema is a rare but typical skin toxicity of bleomycin. We report the case of a boy with a left foot venous malformation who developed this skin rash after two sessions of bleomycin intralesional injection. We discuss the mechanism and characteristics of this reaction to bleomycin, which is usually benign and self-limited. We conclude that, although rare, flagellate pigmentation can occur when bleomycin is used as a sclerosant in children.Bleomycin is an antibiotic with cytotoxic properties, commonly used in combination regimens for the treatment of Hodgkin's and non-Hodgkin's lymphoma; squamous cell carcinoma of the head and neck; and germ cell, gynecologic, and skin tumors.1 In addition to its antitumor activity, bleomycin is used as a sclerosant in the treatment of vascular malformations and in recurrent malignant pleural effusions.1 Bleomycin-induced toxicities are more common in the lungs and skin because of a lower activity of bleomycin hydrolase in these organs. 2The reported dermatologic side effects of bleomycin include alopecia, Raynaud's syndrome, hyperkeratosis, nail bed changes, palmar and plantar desquamation, eczematous changes, digital gangrene, and pigmentary alterations. 3,4 Less commonly, skin toxicity presents as flagellate erythema, a unique drug rash that appears as "whiplike" linear streaks. It may affect the face, trunk, or limbs. 5Moulin first described it in 1970. 6Although the use of bleomycin as an antineoplastic agent has been decreasing, 5 there has been growing interest in its use as a sclerosant because of the low risk of side effects and its low cost. In addition, patients recover quickly, with good outcomes. 7We report a case of bleomycin-associated flagellate erythema after intralesional injection of a venous malformation and discuss the mechanism and characteristics of this reaction. | CASE REPOR TWe report the case of a 14-year-old boy with a venous malformation (VM) in the left lower limb. He underwent partial excision of the lesion at the age of 9 years. The postoperative period was complicated by a hematoma and skin ulceration, which was managed using local wound care. There was no other significant past medical or surgical history and no dermatologic disorders or allergies. A skin biopsy of a lesion on his left flank was obtained. Pathologic examination showed lymphocytic and histiocytic infiltration around

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“…The efficacy of MDA was assessed intraoperatively, using the above-described sonographic features of successful ablation, and with the same diagnostic modality at follow ups [35,36]. In contrast to foam sclerotherapy, in which the extent of ablation is rather unpredictable, MDA enables precise closure of target veins [37][38][39]. Without tumescence the distance between the tip of the needle inserted to the subfascial part of perforator and the deep veins is approximately 3-4 mm, after tumescence this distance increases to 10-15 mm.…”

Section: Discussionmentioning

confidence: 99%

Authors’ own method of diathermic thermal ablation of venous perforators – surgery with protective tumescence

Kuśnierczyk¹,

Nowakowski²

2016

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Objectives: Low-invasive endovenous thermal ablation techniques have become the preferred modality for the treatment of incompetent perforating veins. Material and methods:We managed 210 varicose-vein patients (268 limbs) presenting with coexisting superficial and perforator incompetence. We utilised bipolar radiofrequency ablation for the treatment of incompetent superficial veins and monopolar diathermal ablation under protective tumescence to manage incompetent perforators. To ablate incompetent perforating veins with monopolar diathermy we used a modified peripheral intravenous catheter with a long needle for administration of tumescence. Results: The success rate of thermal ablation of incompetent perforating veins, defined as completely occluded perforators demonstrated by Doppler sonography at one-year follow-up, was 95%. A similarly defined success rate of radiofrequency closure of incompetent superficial veins was 97%. There were no serious intraoperative complications such as deep vein thrombosis, peripheral nerve injuries, skin burns or persistent hyperpigmentations. There were transient hypoesthesias in 20% of patients presenting with incompetent Cockett I and Cockett II perforators. In addition, 96% of patients presenting with active ulcers had their ulcers healed 30-60 days after the procedure. Conclusions: Monopolar diathermy with the use of protective tumescence enables minimally invasive, effective, and precise ablation of incompetent perforators. This method is also safe, with no associated injury to adjacent anatomical structures or thromboembolic complications.

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Sclerotherapy complications of peripheral venous malformations

Cited by 34 publications

References 41 publications

Percutaneous sclerotherapy for spongiform venous malformations – analysis of patient-evaluated outcome and satisfaction

Percutaneous sclerotherapy for spongiform venous malformations – analysis of patient-evaluated outcome and satisfaction

Bleomycin‐induced flagellate erythema after venous malformation sclerosis—Case report and brief review

Authors’ own method of diathermic thermal ablation of venous perforators – surgery with protective tumescence

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