Sclerotherapy in the treatment of congenital venous and lymphatic malformation: Efficacy and safety with long-term follow-up

Background: Surgical excision and alcohol sclerotherapy have been used to treat congenital vascular malformations (CVM) with a significant success rate but the methods have also left marked morbidity. The alternative, sclerotherapy using ordinary sclerosants, although resulting in trivial complications, has a relatively low cure rate and is rarely used in Korea for CVM management. Objective: To evaluate the effects and side effects of sclerotherapy using ordinary sclerosants such as polidocanol (POL) and sodium tetradecyl sulfate (STS) for the treatment of CVM of a venous and lymphatic type. Methods: To confirm the long-term effects and safety with at least a 3-year follow-up, we chose a total of 26 patients who had undergone sclerotherapy between 2000 to 2004. There were 22 venous malformations (VMs) and 4 lymphatic malformations (LMs) which were rather small and superficial, not beyond muscular fascia. Sclerotherapy using POL and STS was performed by blind intraluminal and/or intralesional injection without the aid of imaging methods such as ultrasound examination. The results were evaluated by the patients' subjective satisfaction, physical examination, comparison of photographs and/or radiological examinations, then they were classified into 4 groups; excellent (improvement >75%), good (50-75%), fair (25-49%) and poor (<25%). Results: Twenty two VMs comprised 14 in the excellent group (66.7%), 6 in the good group (25.0%), 1 in the fair group (4.2%) and 1 in the poor group (4.2%). Two LMs of macrocystic type revealed excellent results but the other two showing microcystic type revealed poor results. The dose of sclerosant was 0.1 to 2 ml in every session and a total of 1 to 6 sessions (average: 2.2) were performed. Only one VM showed hyperpigmentation as a side effect. Conclusion: Sclerosants for ordinary varicose vein eradication can be used on the treatment of small and superficial venous malformations and macrocystic-lymphatic malformations with relative efficacy and safety.