Treatment Outcomes and Effects of Ethanol Sclerotherapy on Systemic Coagulation Profile of Patients with Venous Malformation

Yu, Ming-Wei; Han, Yu-Yu; Wang, Qin; Wang, Min; Chen, Yong; Yuan, Si-Ming

doi:10.1016/j.avsg.2022.03.022

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…We have not observed severe hemolytic gross hematuria requiring intravenous application of binding bead protein. As far as coagulation is concerned, our previous studies have found elevated fibrinogen degradation product and D-D in patients with ethanol sclerotherapy, and this elevation was often associated with a good therapeutic outcome; however, no serious disorders of coagulation were found (10). Among the late postoperative complications, a total of eight patients were observed, and five of them experienced muscle contracture, which was relieved in three patients after regular stretching of the contracted muscles and the corresponding rehabilitation treatment.…”

Section: Discussionmentioning

confidence: 91%

Therapeutic evaluation and analysis of complications of ethanol sclerotherapy for intramuscular vascular malformations: a single-center retrospective study

Jin,

Wang,

Wang

et al. 2023

Front. Surg.

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BackgroundIntramuscular venous malformations (IMVMs) can cause pain and contracture deformity, leading to dysfunction of limbs. Ethanol sclerotherapy is one of the main treatments for IMVMs. This study aims to evaluate the efficacy and the complications associated with intravascular ethanol sclerotherapy for IMVMs and to provide a comprehensive summary of clinical experiences for future reference.MethodsA retrospective analysis was conducted on a cohort of 118 patients diagnosed with IMVMs who were treated with ethanol sclerotherapy in our center between 2006 and 2021. The plastic surgeons utilized a standardized collection pro forma to record the clinical data. Furthermore, a follow-up period ranging from 6 months to 5 years was implemented to assess the relief of symptoms, the change of lesion size, and the recovery of functional outcomes. In addition, an analysis of long-term complications was conducted.ResultsThe clinical symptoms of the patients in this group included pain, swelling, and limited movement. On average, 5.61 mL (range 2–14 mL) of ethanol was used during the sclerotherapy procedure. The intraoperative and early postoperative complications were successfully relieved by means of timely intervention, as observed during the follow-up period. Based on the MRI results, the sizes of the lesions in 19% of the cases were significantly decreased, while a slight decrease was observed in 39% of the cases. During the follow-up period, it was found that only eight out of the 118 patients included in this study experienced long-term complications related to sclerotherapy.ConclusionsAlthough ethanol sclerotherapy has proven to be an effective first-line treatment for IMVMs, it is associated with a variety of adverse reactions and short- and long-term complications. Surgeons are required to perform operations prudently and provide timely medical intervention for postoperative complications.

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Section: Discussionmentioning

confidence: 91%

Therapeutic evaluation and analysis of complications of ethanol sclerotherapy for intramuscular vascular malformations: a single-center retrospective study

Jin,

Wang,

Wang

et al. 2023

Front. Surg.

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“…Previous studies have also reported a positive correlation between changes in fibrinogen degradation product and D-Dimer levels and treatment outcomes. 39 Predictors of lesion volume change and subjective measures vary widely in previous reports, with some studies finding no predictive factors, while some factors, such as size, lesion diffusion, sex, and number of sclerotherapy sessions have been reported to impact sclerotherapy outcomes. 16,30,[40][41][42] There is still no clear consensus on the definition and evaluation of treatment efficacy for VMs.…”

Section: Discussionmentioning

confidence: 97%

Clinical outcomes and predictors of bleomycin polidocanol foam sclerotherapy treatment response in venous malformations

Ni,

Liu,

Fan

et al. 2024

J Int Med Res

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Objective To evaluate the safety and efficacy of bleomycin polidocanol foam (BPF) sclerotherapy for venous malformations (VMs) and analyze the associated clinical outcomes and predictors. Methods We retrospectively assessed BPF sclerotherapy outcomes in 138 patients with VMs. We analyzed pain levels, lesion volume reduction, and subjective perception of response. Logistic regression analysis was performed to identify potential predictors of treatment outcome. Additionally, we carefully monitored and recorded complications. Results There was a notable average reduction in lesion volume by 78.50% ± 15.71%. The pain numerical rating scale (NRS) score decreased from 4.17 ± 2.63 prior to treatment to 1.05 ± 1.54 afterward, and 70.3% of the patients experienced effective relief after a single BPF treatment. Multivariate analysis revealed that a high baseline NRS (odds ratio [OR]: 4.026) and elevated activated partial thromboplastin time (APTT, OR: 1.200) were positive predictors of pain reduction. Additionally, a high baseline NRS score (OR: 1.992) and elevated thrombocytocrit (PCT, OR: 2.543) were positive predictors of incomplete postoperative pain relief. Minor complications occurred in 31 (22.46%) patients. Conclusion BPF sclerotherapy is safe and effective for VMs, resulting in significant reduction in lesion volume, improved symptoms, and minimal complications. APTT and PCT levels are important predictors of pain outcomes following BPF treatment.

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A long-term follow-up study of the changes in localized intravascular coagulation-related indexes after sclerotherapy of venous malformation

Zheng,

Zhong,

Sun

et al. 2024

Phlebology

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Objective Localized intravascular coagulation (LIC) is a unique phenomenon associated with venous malformations (VMs). This study investigated the changes in LIC related indexes following sclerotherapy of VMs and its correlation with therapeutic efficacy. Methods From August 2019 to September 2023, patients who met the following criteria were enrolled into this study: (1) individuals with venous malformations accompanied by LIC; (2) those who had undergone a minimum of three sclerotherapy sessions; (3) blood coagulation function tests were conducted prior to each treatment; and (4) magnetic resonance imaging (MRI) scans were conducted both before and after three times of treatment. Those who fail to meet with the previous inclusion criteria were excluded. The coagulation profile prior to each sclerotherapy treatments was assessed. The therapeutic outcomes were evaluated at the end of treatment. Results A total of 21 patients were enrolled into the study, with the age ranging from 4 to 61 years old. Elevated D-dimer levels, with or without a decrease in fibrinogen (FIB) and an increase in fibrin degradation products (FDP) are clinical features of VMs with LIC. The coagulation indexes tend to settle down with several sclerotherapy treatments. There were 5 cases in the significantly improved group, 13 cases in the improved group, and 3 cases in the no improved group when it came to efficacy assessment. The better therapeutic efficacy is more pronounced the improvement of LIC. Conclusions LIC gradually returns to normal during sclerotherapy, and the degree of recovery is directly related to the treatment’s efficacy. One useful metric to evaluate the effectiveness of sclerotherapy for VMs is the improvement of LIC.

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Treatment Outcomes and Effects of Ethanol Sclerotherapy on Systemic Coagulation Profile of Patients with Venous Malformation

Cited by 5 publications

References 26 publications

Therapeutic evaluation and analysis of complications of ethanol sclerotherapy for intramuscular vascular malformations: a single-center retrospective study

Therapeutic evaluation and analysis of complications of ethanol sclerotherapy for intramuscular vascular malformations: a single-center retrospective study

Clinical outcomes and predictors of bleomycin polidocanol foam sclerotherapy treatment response in venous malformations

A long-term follow-up study of the changes in localized intravascular coagulation-related indexes after sclerotherapy of venous malformation

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