Image: Venous malformation of the arm-elbow
Sclerotherapy is a very common treatment for patients with slow flow vascular malformations such as venous, lymphatic or mixed venous and lymphatic malformations. This treatment promotes inflammation within the malformation, promoting it to “internally scar” and reduce in size. This in turn helps with symptoms such as fullness/bulkiness and pain.
Image: US guided access of lymphatic malformation, arrows pointing to needle.
The procedure is performed in Interventional Radiology with your child typically under general anesthesia. We will first perform an ultrasound to further characterize the malformation. Afterward, using ultrasound, a needle will be directed into the malformation followed by contrast injection. The contrast will be followed by fluoroscopy (x-ray) to monitor the flow. If the contrast fills out the appropriate portions of the malformation, a special chemical called the sclerosant will be injected. This portion of the procedure may be repeated in this setting depending on the size and distribution of the sclerosant.
Image: Lymphatic malformation of neck
Most patients do get discharged home the same day following the procedure. The exception would be those patients with an underlying bleeding disorder or those with malformations around the head or neck. Your child will have to take it easy for several days. If the treatment involved the leg or foot, they will be required to use crutches or a walker for about 5 days. Placing ice packs to the sclerotherapy sites will help with pain and swelling. Staying well hydrated after the procedure is also very important.
It is not unusual to have bruising, swelling or firmness to the treatment sites. You will be given a phone number to call if you have any questions or concerns once you are discharged home. The treatment is usually repeated in 6 to 8 weeks. Do not hesitate to call Interventional Radiology prior to your child’s procedure if you have any questions.
Contributed by Dr. Manish N. Patel and edited by Wendy Bankes.
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