ThisarticleappearedinajournalpublishedbyElsevier.Theattachedcopyisfurnishedtotheauthorforinternalnon-commercialresearchandeducationuse,includingforinstructionattheauthorsinstitutionandsharingwithcolleagues.Otheruses,includingreproductionanddistribution,orsellingorlicensingcopies,orpostingtopersonal,institutionalorthirdpartywebsitesareprohibited.Inmostcasesauthorsarepermittedtoposttheirversionofthearticle(e.g.inWordorTexform)totheirpersonalwebsiteorinstitutionalrepository.AuthorsrequiringfurtherinformationregardingElsevier’sarchivingandmanuscriptpoliciesareencouragedtovisit:http://www.elsevier.com/copyrightAuthor'spersonalcopyFluoroscopy-guidedfoamsclerotherapywithsodiummorrhuateforperipheralvenousmalformations:PreliminaryexperienceLongLi,MD,aJieFeng,MD,bXin-QiaoZeng,BMed,candYan-HaoLi,MD,aGuangzhou,Guangdong,ChinaBackground:Ultrasound-guidedfoamsclerotherapyisagenerallysafe,cost-effective,andpracticaltechniqueforthetreatmentofcertainvenousmalformations;however,notallvascularmalformationlesionsareamenabletotheultrasound-guidedmethod.Venousoutflowofthesclerosingagentandextravasationaredifficulttocheckwhenonlyultrasoundguidanceisused.Thisstudydescribesanewfluoroscopy-guidedtechniquethatusesstandardizedsclerosingfoamforperipheralvenousmalformations.Theshort-termefficacyandsafetyoffluoroscopy-guidedfoamsclerotherapyforperipheralvenousmalformationswasevaluated.Methods:Aretrospectivereviewofaprospectivelycollecteddatawasperformedfor23patients(9males,14females)withlimited(localized)venousmalformationstreatedwithfoamsclerotherapywhowerereferredfromJanuary2007toDecember2007.Medianpatientagewas21years(range,5months-39years).Lesionlocationsincludedextremitiesin13,facesineight,andtrunksintwo.ThestandardizedsclerosingfoamwaspreparedusingTessari’smethodtomixroomairwith5%sodiummorrhuateina4:1ratio.Sclerotherapywasperformedbythe“filling-defects”techniqueunderfluoroscopy.Postsclerotherapysurveillancewasdoneat6monthsafterthelastsession.Treatmentresponsewasassessedclinicallyandbymeansoflesionsizemeasurementwithmagneticresonanceimaging.Duringthetreatmentandthefollow-upperiod,adverseeventsandadversedrugreactionswererecorded.Specificcomplicationswereclassifiedasmajororminor.Results:Atotalof58treatmentsessionswereperformed(mean,3sessionsperpatient;range,1-6sessions).Atthe6-monthfollow-up,15patients(65.2%)showedatotaldisappearanceoftreatedmalformations,six(26.1%)showedareductioninmalformationsizeof>50%,andtwo(8.7%)showedareductioninmalformationsizeof<50%.Theoverallpatient-reportedoutcomewasexcellentin11(47.8%),goodin8(34.8%),ormoderatein4(17.4%).Minorcomplicationsincludedswellingandinflammatoryreactionpersession,mildpainin17sessions(29.3%),andskinblisterattheinjectionsiteintwosessions(3.4%),whichresolvedspontaneouslywithinseveraldaysto2weeks.Nomajorcomplicationsoccurred.Conclusion:Fluoroscopicguidancecouldhavegreatpromiseinfoamsclerotherapyofperipheralvenousmalformations,althoughlargerstudiesarenecessarytodeterminetheadvantagesofthistechniqueoverothersclerotherapeuticmethods.(JVascSurg2009;49:961-7.)Venousmalformationsaredifficulttotreat.Varioustreatmentmodalities,rangingfromirradiation,electroco-agulation,intravascularneedles,andalonglistofsclero-sants,havebeendescribedfortheirmanagement.1Surgicalexcisionisdifficult,andoftencompleteremovalisnotpossible.Surgicaltreatmentofmoreextensivelesio...
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