Clinical efficacy of absolute ethanol combined with n-butyl cyanoacrylate sclerotherapy in the treatment of Puig's classified advanced venous malformation in children

Digital Subtraction Angiography-Guided Foam Sclerotherapy with Polidocanol for Treating Superficial Venous Malformation

Objective: This study aims to describe the angiographic imaging characteristics of superficial venous malformations and evaluate the treatment effectiveness of digital subtraction angiography (DSA)-guided foam sclerotherapy with polidocanol.

Materials and Methods: This prospective study was conducted in 18 patients with venous malformation treated by DSA-guided sclerotherapy. Treatment outcomes were evaluated based on pain improvement and reduction in lesion size on magnetic resonance imaging (MRI) 6-months posttreatment.

Results: A total 21 lesions and 46 sclerotherapy sessions were analyzed. MRI findings presented 8/21 lesions (38.1%) with excellent response, 9/21 (42.9%) with good response, and 3/21 (14.3%) with average response, while one patient (4.8%) showed no response. All patients experienced pain. A significant reduction (p<0.01) was observed in the pre- to posttreatment pain score (5.45 and 0.64, respectively). Over a follow-up period of 1–4 years, three out of four patients (75%) in the retrospective cohort experienced recurrence; one patient had an increased lesion size and pain score, while the other two patients only showed an increased lesion size. No severe complications were seen.

Conclusion: DSA-guided sclerotherapy with polidocanol is a safe and effective procedure for reducing lesion size and pain in symptomatic patients with superficial venous malformations.