Sonographically guided percutaneous sclerosis using 1% polidocanol in the treatment of vascular malformations.

Abstract

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.

• Authors: Rajeev Jain, Suman Bandhu, Sukhpal Sawhney, Ravi Mittal
• Journal: Journal of clinical ultrasound : JCU (J Clin Ultrasound) Vol. 30 Issue 7 Pg. 416-23 (Sep 2002) ISSN: 0091-2751 [Print] United States
• PMID: 12210459 (Publication Type: Journal Article)
• Copyright: Copyright 2002 Wiley Periodicals, Inc.

Chemical References

• Sclerosing Solutions
• Polidocanol
• Polyethylene Glycols

Topics

• Adolescent
• Adult
• Arteriovenous Malformations (therapy)
• Child
• Extremities (blood supply)
• Humans
• Injections, Intralesional
• Lymphangioma (therapy)
• Polidocanol
• Polyethylene Glycols (administration & dosage)
• Prospective Studies
• Sclerosing Solutions (administration & dosage)
• Sclerotherapy
• Ultrasonography, Doppler, Color
• Ultrasonography, Interventional
• Veins (abnormalities)