Quality of life and clinical results after endovascular sclerotherapy: A comparison between intra- and extramuscular low-flow venous malformations

Abstract

Background

Based on clinical observations we hypothesized that patients with intramuscular venous malformations (VMs) did worse or needed more sclerotherapy sessions than patients with extramuscular VMs.

Purpose

To evaluate the difference in treatment and quality of life (QOL) results after Polidocanol sclerotherapy of intra- and extramuscular low-flow VMs.

Material and methods

Forty-one patients with a VM were treated with Polidocanol in two university hospitals. The results were retrospectively analyzed. Pre- and post-treatment magnetic resonance imaging (MRI) scans were compared. All patients completed a self-evaluating form on symptoms as well as a QOL questionnaire. The results were compared between two groups: intra- and extramuscular VM’s.

Results

No statistically significant differences between intra- and extramuscular groups concerning QOL and specific dimensions pain, functional problems or cosmetic appearance were found. Radiological changes in MRI examinations did not correlate with any of the subjective symptoms. 56% of the patients benefitted from the treatment according to patient self-evaluation.

Conclusion

In this material intramuscular VM’s responded to the treatment comparably to extramuscular malformations. Post-treatment MRI findings do not correlate with subjective symptoms or QOL results and thus, a routine post-treatment examination seems to be unwarranted. Subjective symptoms and QOL results are the most important parameters in evaluating the effectiveness of sclerotherapy.

Keywords

Intramuscular extramuscular venous malformation quality of life sclerotherapy

Get full access to this article

View all access options for this article.

References

Fishman

Mulliken

JB.

Vascular anomalies: a primer for pediatricians. Pediatr Clin North Am 1998; 45: 1455–1477.

Dubois

Garel

Imaging and therapeutic approach of hemangiomas and vascular malformations in the pediatric age group. Pediatr Radiol 1999; 29: 879–893.

Greene

Vascular anomalies classification, diagnosis & management. St. Louis, MO: Quality Medical Publishing, 2013.

Vogel

Hess

Dowd

, et al. Early versus later presentations of venous malformations: where and why? Pediatr Dermatol 2013; 30: 534–540.

Wieck

Nowicki

Schall

, et al. Management of pediatric intramuscular venous malformations. J Pediatr Surg 2017; 52: 598–601.

Scorletti

Patel

Hammill

, et al. Sclerotherapy for intramuscular vascular malformations: a single-center experience. J Pediatr Surg 2018; 53: 1056–1059.

Hassanein

Mulliken

Fishman

, et al. Venous malformation risk of progression during childhood and adolescence. Ann Plast Surg 2012; 68: 198–201.

Van der Vleuten

Kater

Wijnen

, et al. Effectiveness of sclerotherapy, surgery, and laser therapy in patients with venous malformations: a systemic review. Cardiovasc Intervent Radiol 2014; 37: 977–989.

Mccafferty

Management of low-flow malformations: clinical presentation, classification, patient selection, imaging and treatment. Cardiovasc Intervent Radiol 2015; 38: 1082–1104.

10.

Launois

Reboul-Marty

Henry

Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ). Qual Life Res 1996; 5: 539–554.

11.

Aalto

A-M

Aro

Teperi

Rand-36 as a measure of health-related quality of life. Reliability, construct validity and reference values in Finnish general population (in Finnish). National Research and Development Center for Welfare and Health, Research Reports 101. Saarijärvi: Gummerus, 1999.

12.

Asdahl

Hedelund

Keller

, et al. Outcome measures after sclerotherapy of venous malformations: a systematic review. Cardiovasc Intervent Radiol 2018; 41: 1141–1151.

13.

Dompmartin

Vikkula

Boon

LM.

Venous malformation: update on aetiopathogenesis, diagnosis and management. Phlebology 2010; 25: 224–235.

14.

Horbach

SER

van de Ven

Nieuwkerk

, et al. Patient-reported outcomes of bleomycin sclerotherapy for low-flow vascular malformations and predictors of improvement. Cardiovasc Intervent Radiol 2018; 41: 1494–1504.

15.

Bianchini

Camilli

Furgiuele

Intramuscular venous malformations of the upper and lower limbs: indications and outcomes of sclerotherapy. Cardiovasc Intervent Radiol 2018; 41: 1505–1512.

16.

Rabe

Pannier

Sclerotherapy in venous malformation. Phlebology 2013; 28: 188–191.

17.

Howard

Mattacola

Howell

Response shift theory: an application for health-related quality of life in rehabilitation research and practice. J Allied Health 2011; 40: 31–38.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.33 MB