Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.
Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
J Vasc Interv Radiol. 2023 Dec;34(12):2103-2109. doi: 10.1016/j.jvir.2023.08.032. Epub 2023 Aug 26.
To assess the effectiveness, safety, and predictors of outcomes and adverse events for percutaneous sclerotherapy using polidocanol for the treatment of venous malformations (VMs).
A retrospective single-center analysis was performed, including patients with VMs who were treated with sclerotherapy using polidocanol between January 2011 and November 2021 at a tertiary center. Demographic characteristics, clinical data, and radiologic features were analyzed, and the influence of patient- and VM-related factors on the subjective clinical outcome and adverse events were investigated using a multivariate logistic regression analysis.
In total, 167 patients who received 325 treatment sessions were included in this study. Overall symptom improvement was observed in 67.5%, stable symptoms were observed in 25.0%, and worsening was reported in 7.5% (clinical follow-up, 1.04 ± 1.67 years). The total adverse event rate was 10.2%, with an overall rate of 4.2% for permanent adverse events within the cohort. In multivariate analysis, the clinical outcome was worse in children (P = .01; 57.1% symptom improvement in children [age, <18 years] and 79.7% in adults), and adverse events were more frequently observed after the treatment of VMs located at the extremities (P < .01; 8.4% for VMs of the extremities and 1.2% for VMs in other locations).
Sclerotherapy using polidocanol can be an effective treatment option for VMs with an acceptable safety profile. However, it can be less effective in children, and adverse events can be more frequently expected for VMs of the extremities.
评估使用聚多卡醇行硬化治疗治疗静脉畸形（VM）的疗效、安全性，以及结局和不良事件的预测因素。
回顾性分析 2011 年 1 月至 2021 年 11 月在一家三级中心接受聚多卡醇硬化治疗的 VM 患者。分析人口统计学特征、临床资料和影像学特征，并采用多变量逻辑回归分析研究患者和 VM 相关因素对主观临床结局和不良事件的影响。
本研究共纳入 167 例患者，共进行 325 次治疗。67.5%的患者症状总体改善，25.0%的患者症状稳定，7.5%的患者症状恶化（临床随访 1.04±1.67 年）。总不良事件发生率为 10.2%，队列中永久性不良事件的总发生率为 4.2%。多变量分析显示，儿童的临床结局较差（P=0.01；年龄<18 岁的儿童症状改善率为 57.1%，而成人为 79.7%），四肢 VM 的治疗后更常发生不良事件（P<0.01；四肢 VM 的不良事件发生率为 8.4%，其他部位的 VM 为 1.2%）。
使用聚多卡醇行硬化治疗治疗 VM 是一种有效且安全的治疗方法。然而，其在儿童中的疗效可能较差，四肢 VM 治疗后更常发生不良事件。
