Digital subtraction angiography-guided foam sclerotherapy of peripheral venous malformations.

Abstract

The purpose of this article is to describe a modified technique of using digital subtraction angiography guidance combined with the double-needle technique and the filling-defects technique for foam sclerotherapy of peripheral venous malformations. The short-term efficacy and safety of the technique were evaluated. Fourteen patients with peripheral venous malformations were treated with foam sclerotherapy. Sclerosing foam was prepared using the Tessari method to mix room air with 5% sodium morrhuate in a 4:1 ratio. Percutaneous foam sclerotherapy of venous malformations under digital subtraction angiography guidance was performed using a combined technique modified with the double-needle technique and the filling-defects technique. Follow-up clinical and radiologic assessment and evaluation of patient satisfaction were performed to evaluate the end result. At a mean of 9.3 months (range, 6-12 months) after the last session, the overall outcome was rated as excellent improvement (i.e., clinical obliteration and asymptomatic) in four (28.6%) of 14 patients, good improvement (i.e., substantial improvement in size and symptoms of > 50%) in nine patients (64.3%), or moderate improvement (i.e., significant decrease in size and symptoms of </= 50%) in one patient (7.1%). No major complications occurred. Digital subtraction angiography-guided percutaneous foam sclerotherapy modified with the double-needle technique and the filling-defects technique is an alternative method with favorable short-term results for treating peripheral venous malformations.