THE ROLE OF SCLEROTHERAPY IN TREATMENT OF VASCULAR MALFORMATIONS IN CHILDREN
DOI:
https://doi.org/10.11603/1811-2471.2016.v27.i3.6765Keywords:
vascular malformations, sclerotherapy, detergent agents, OK-432, children.Abstract
Summary. The modern approach in treatment of vascular malformations (VMs) is using of surgical, conservative, endovascular methods, where sclerotherapy plays an important role. The aim of the work was to determine the effectiveness and safety of different types of sclerotherapy of peripheral VMs in children. The study enrolled 96 patients aged from 1 to 17 years in period from January 2011 to March 2016. The follow up period is from 3 to 63 months. Sclerotherapy of venous malformations (VM) was performed in 10 children with pain (n=7), recurrent bleeding (n=2), and psychological discomfort (n=1). Sclerotherapy performed using “foam” of 0.5–1 % of polidocanol or sodium tetradecylsulfat. “Foam” sclerotherapy performed in 2 children with arteriovenous malformations (AVM) after previous embolization. Sclerotherapy of cystic lymphatic malformations (LM) using ОК-432 performed in 84 patients. Macrocystic LM were in 34 (40.5 %) children, microcystic LM – in 9 (10.7 %), and mixed in 41 (48.8 %). The results of VM sclerotherapy were cessation of bleeding (n=2), improving the aesthetic appearance (n=2), and pain reduce (n=7). Result of sclerotherapy of VM and AVM are esthetic improving and symptoms decrease, but not curative. In 84 patients with cystic LM performed 194 sessions of sclerotherapy OK-432. The results of macrocystic LM treatment: excellent – 94.1 %, good – 5.8 %; results of treatment of microcystic LM: excellent – 0 %, good – 55.6 %; fair – 33.3 %, poor – 11.1 %; results of mixed LM treatment: excellent – 19.5 %, good – 61.0 %; fair – 17.1%, poor – 2.4 %. Complication of treatment - allergic skin reaction – occurs in one (1.1 %) patient. Sclerotherapy is effective and safety treatment method of VMs in children. For the treatment of VM and AVM foam detergents were used, for treatment of cystic LM OK-432 was used. Excellent and good results of LM sclerotherapy received in 85.7 % of patients. Using sclerotherapy in patients with VM and AVM we receive the symptom control, but LM with macrocystic component prevalence can be treated successfully.
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