Optimizing treatment selection in venous malformations through imaging-assisted sequential therapy: a case series analysis

Objective

Venous malformations (VMs) are the most prevalent slow-flow congenital vascular anomalies. Effective management of VMs often necessitates individualized approaches, particularly for lesions with significant interstitial components. This study aims to evaluate a sequential treatment strategy combining sclerotherapy and open surgery, with guidance from ultrasound (US) and magnetic resonance imaging (MRI).

Methods

A retrospective analysis was performed on a case series of 10 patients with VMs. Each patient underwent initial sclerotherapy, followed by surgical intervention. Preoperative US and MRI were used to assess treatment progress and optimize the timing of surgery.

Results

Sclerotherapy effectively reduced the venous components of VMs by inducing fibrosis, which diminished blood supply and facilitated subsequent surgical excision. Sequential plastic surgical resection successfully removed the interstitial components, further improving outcomes, particularly in cosmetically sensitive areas. Imaging modalities played a key role in monitoring the treatment process; US was effective for superficial lesions, whereas MRI provided essential insights into deeper and more complex malformations.

Conclusions

Sequential treatment, incorporating preoperative sclerotherapy and tailored surgical planning, is essential for the effective management of VMs. Further research with larger, multicenter studies is needed to validate these findings and optimize treatment protocols.