Current concepts in diagnosis and treatment of venous malformations.
INTRODUCTION
Venous malformations are the most common type of vascular malformation, usually detected at birth or during puberty. By occurring during human growth or through localized trauma, pain, functional impairment and aesthetic disfigurement is often observed. Ultrasonography, Doppler flow Imaging, and Magnetic Resonance Imaging are the most informative techniques which reveal the extent of tissue involvement and differentiate between high and low flow anomalies. Therapeutic options for treatment of venous malformations are sclerotherapy with alcohol, ethoxysclerol and bleomycin, laser therapy (Nd:YAG), surgery and combined therapeutic modalities. The aim of percutaneous sclerotherapy is the successive reduction of the volume of the lesion by aseptic inflammation.


PATIENTS AND METHODS
This is a review of 51 patients with venous malformation treated by the Interdisciplinary Center for Vascular Anomalies at the University Hospital Tübingen, (Germany), from July, 2002 until January, 2007. The mean age of first consultation in our outpatient department was 26.4 years (median). 12 patients were treated by sclerotherapy with highly concentrated alcohol, 9 by surgery, and 7 by laser therapy. In some cases we combined different treatments. 9 patients had only sclerotherapy, while 3 had a combination of pre-operative sclerotherapy and surgery.


RESULTS
We obtained positive results in patients treated with sclerotherapy and combined sclerotherapy and surgery.


CONCLUSION
Sclerotherapy is safe (under fluoroscopic control), efficient, and can be repeated multiple times. Therefore, it should be considered as first-line treatment in venous malformations. A combination of a sclerotherapy with surgery is also useful in many cases.
['Judith|Neuschl|N|', 'Ulrike|Ernemann|E|', 'Siegmar|Reinert|R|', 'Matthias|Neuschl|N|', 'Jürgen|Hoffmann|H|']
D000293:Adolescent D000328:Adult D000368:Aged D001761:Bleomycin D002648:Child D002675:Child, Preschool D003131:Combined Modality Therapy D000431:Ethanol D005260:Female D006801:Humans D007223:Infant D053685:Laser Therapy D053844:Lasers, Solid-State D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D000077423:Polidocanol D011092:Polyethylene Glycols D012039:Regional Blood Flow D012597:Sclerosing Solutions D015911:Sclerotherapy D018608:Ultrasonography, Doppler D054079:Vascular Malformations D055815:Young Adult
Venous malformations Vascular malformation Sclerotherapy Laser therapy Aethoxysclerol