Sonographically guided percutaneous sclerosis using 1% polidocanol in the treatment of vascular malformations
✍ Scribed by Rajeev Jain; Suman Bandhu; Sukhpal Sawhney; Ravi Mittal
- Publisher
- John Wiley and Sons
- Year
- 2002
- Tongue
- English
- Weight
- 291 KB
- Volume
- 30
- Category
- Article
- ISSN
- 0091-2751
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✦ Synopsis
Purpose:
The aim of this prospective study was to assess the safety and efficacy of sonographically guided percutaneous injection of 1% polidocanol for sclerosis of peripheral vascular malformations.
Methods:
Patients with vascular malformations of soft tissues were invited to enroll in the study. gray-scale and color doppler sonography were performed to determine the texture, margins, and size of the lesions and to determine whether high-velocity blood flow was present. using real-time sonographic guidance, lesions were punctured with a 20/21-gauge spinal needle. when possible, venous return was occluded before injection. for each injection, 1-6 ml of 1% polidocanol was injected into 1 or more sites within the lesion. the sclerosing agent was not aspirated after injection. repeat radiography was performed 1 month after each injection session. the procedure was repeated if the patient did not have a complete response, defined as an 80% or greater decrease in the volume of the lesion or resolution of the presenting symptoms.
Results:
Of the 15 patients enrolled, 9 had venous malformations, 3 had lymphangiomas, 1 had a recurrent aneurysmal bone cyst, 1 had a venous pseudoaneurysm, and 1 had an arteriovenous malformation of the pinna. each patient received 1-20 injections of 1% polidocanol (mean +/- standard deviation, 3.3 +/- 4.8 injections). this treatment resulted in a complete response of 7 venous malformations, 3 lymphangiomas, and the arteriovenous malformation and partial response of 2 venous malformations, the recurrent aneurysmal bone cyst, and the venous pseudoaneurysm. only minor complications occurred.
Conclusions:
Sonographically guided percutaneous injection of 1% polidocanol for sclerosis of peripheral vascular lesions is simple, effective, and safe. this technique is especially effective in cases of soft tissue venous malformation and lymphangioma.