Percutaneous sclerotherapy with gelified ethanol of low-flow vascular malformations of the head and neck region: preliminary results.

Abstract

PURPOSE Evaluation of safety and efficacy of percutaneous sclerotherapy using gelified ethanol in patients with low-flow malformations. METHODS A retrospective study was performed, analyzing treatment and outcome data of 6 patients that presented with 7 low-flow malformations (LF-Ms) (3 lymphatic and 3 venous). Median diameter of LF-Ms was 6 cm (iqr 4.5-8.5 cm). Data regarding pain, functional and/or cosmetic issues were assessed. Diagnosis was performed clinically and confirmed Doppler Ultrasound, while extension of disease was assessed by Magnetic Resonance Imaging (MRI). Percutaneous puncture was performed with 23G needle directly or with ultrasound guidance. All the LF-Ms were treated with gelified ethanol injection. The median volume injected per treatment session resulted 4.4 mL. RESULTS Technical and clinical success were obtained in all cases. No recurrences were registered during a median follow up of 17 months (iqr 12-19 months). Among the 6 patients, 83% of the patients had complete relief (5/6) and the other showed improvement of symptoms. The median VAS score was 7 (iqr 6-7.5) before and 0 (iqr 0-0) after treatment. All patients had functional and aesthetic improvement (100%). Four patients (66.7%) had a very good acceptance and two patients (33.3%) a good acceptance. No major complications neither systemic side effects were observed. CONCLUSION Gelified ethanol may be considered easy to handle, well-tolerated, safe and effective in the short-term follow up. Longer follow up efficacy is mandatory for further conclusions.