Benedict Arasakumar, Donald Rubakan;
Pang, Calver;
Evans, Nicholas;
Papadopoulou, Anthie;
Khalifa, Mohamed;
Tsui, Janice;
Hamilton, George;
... Lim, Chung Sim; + view all
(2023)
Efficacy and safety of foam sclerotherapy with sodium tetradecyl sulfate as the preferred sclerosant of venous malformations based on the experience from a single specialist center.
Journal of Vascular Surgery: Venous and Lymphatic Disorders
, 11
(2)
pp. 379-388.
10.1016/j.jvsv.2022.10.008.
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Abstract
OBJECTIVES: To assess the efficacy and safety of interventional therapy of venous malformations (VM) with foam sclerotherapy as the treatment of choice based on the experience of a single specialist centre. METHODS: All patients with VM who underwent interventional therapy i.e. EST and/or open surgery from January 1st, 2015 - December 31st, 2019 were identified through a prospective database. Types of venous malformation (VM) were classified according to Puig's classification. The outcome measures assessed included efficacy and complications. The former was divided into four groups: no response, mild response, moderate response, and complete response. Complications were defined as any tissue or functional damage, distal embolization or tissue reaction. Continuous variables were compared using analysis of variance (ANOVA) F test and discrete variables were analysed using Chi-squared tests. P<0.05 was considered significant. RESULTS: A total of 207 patients were included. Puig type I lesions were significantly less likely to be treated with foam sclerotherapy using STS 3% (p=<0.001), and more likely surgically excised (p=<0.001). In the patient's first procedure during the study period, the volumes of foam STS 3% were significantly different across all types of VM (p=<0.001); patients with type I VM received less volume of STS 3% when compared to those with type II and III lesions. The efficacy outcome categories were significantly different across all types of VM (p=<0.001). Overall only 14 (6.8%) patients reported no improvement in efficacy, and 38 patients 38 (18%) patients did not attend follow-up. Therefore 154 (74.8%) patients achieved some form of efficacious outcome. Ten (4.8%) patients experienced complications such as hematoma, thrombophlebitis and ulceration. The proportions of complication were significantly different across the categories (p=0.030) with more complications reported in type I VM. CONCLUSIONS: Interventional therapy with foam sclerotherapy using STS 3% is clinically effective and safe for patients with VM and was most successful among Puig's type I and II VM.
| Type: | Article |
|---|---|
| Title: | Efficacy and safety of foam sclerotherapy with sodium tetradecyl sulfate as the preferred sclerosant of venous malformations based on the experience from a single specialist center |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jvsv.2022.10.008 |
| Publisher version: | https://doi.org/10.1016/j.jvsv.2022.10.008 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Embolo-sclerotherapy, foam sclerotherapy, Interventional therapy, low-flow vascular malformation |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10160479 |
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