Rimon U, Garniek A, Galili Y, Golan G, Bensaid P, Morag B
Department of Diagnostic Imaging, Interventional Radiology Sectionm Chaim Sheba Medical Center, Tel-Hashomer, 52621, Israel.
Eur J Radiol. 2004 Dec;52(3):283-7. doi: 10.1016/j.ejrad.2003.09.010.
Venous malformations are congenital lesions that can cause pain, decreased range of movement, compression on adjacent structures, bleeding, consumptive coagulopathy and cosmetic deformity. Sclerotherapy alone or combined with surgical excision is the accepted treatment in symptomatic malformations after failed treatment attempts with tailored compression garments.
To report our experience with percutaneous sclerotherapy of peripheral venous malformations with ethanol 96%.
41 sclerotherapy sessions were performed on 21 patients, aged 4-46 years, 15 females and 6 males. Fourteen patients were treated for painful extremity lesions, while five others with face and neck lesions and two with giant chest malformations had treatment for esthetic reasons. All patients had a pre-procedure magnetic resonance imaging (MRI) study. In all patients, 96% ethanol was used as the sclerosant by direct injection using general anesthesia. A minimum of 1-year clinical follow-up was performed. Follow-up imaging studies were performed if clinically indicated.
17 patients showed complete or partial symptomatic improvement after one to nine therapeutic sessions. Four patients with lower extremity lesions continue to suffer from pain and they are considered as a treatment failure. Complications were encountered in five patients, including acute pulmonary hypertension with cardiovascular collapse, pulmonary embolus, skin ulcers (two) and skin blisters. All patients fully recovered.
Sclerotherapy with 96% ethanol for venous malformations was found to be effective for symptomatic improvement, but serious complications can occur.
静脉畸形是先天性病变，可导致疼痛、活动范围减小、对相邻结构的压迫、出血、消耗性凝血病和外观畸形。在尝试使用定制压迫衣治疗失败后，单独硬化治疗或联合手术切除是有症状畸形的公认治疗方法。
报告我们使用96%乙醇经皮硬化治疗周围静脉畸形的经验。
对21例年龄在4至46岁之间的患者进行了41次硬化治疗，其中女性15例，男性6例。14例患者因肢体疼痛性病变接受治疗，另外5例面部和颈部病变患者以及2例巨大胸部畸形患者因美容原因接受治疗。所有患者在治疗前均进行了磁共振成像（MRI）检查。所有患者均在全身麻醉下通过直接注射使用96%乙醇作为硬化剂。进行了至少1年的临床随访。如有临床指征，则进行随访影像学检查。
17例患者在一至九次治疗后症状完全或部分改善。4例下肢病变患者仍有疼痛，被视为治疗失败。5例患者出现并发症，包括急性肺动脉高压伴心血管衰竭、肺栓塞、皮肤溃疡（2例）和皮肤水泡。所有患者均完全康复。
发现使用96%乙醇进行硬化治疗对静脉畸形的症状改善有效，但可能会发生严重并发症。
