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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

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. Green open access

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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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