Digital subtraction angiography-guided foam sclerotherapy of peripheral venous malformations.

OBJECTIVE: The purpose of this article is to describe a modified technique of using digital subtraction angiography guidance combined with the double-needle technique and the filling-defects technique for foam sclerotherapy of peripheral venous malformations. The short-term efficacy and safety of the technique were evaluated.

MATERIALS AND METHODS: Fourteen patients with peripheral venous malformations were treated with foam sclerotherapy. Sclerosing foam was prepared using the Tessari method to mix room air with 5% sodium morrhuate in a 4:1 ratio. Percutaneous foam sclerotherapy of venous malformations under digital subtraction angiography guidance was performed using a combined technique modified with the double-needle technique and the filling-defects technique. Follow-up clinical and radiologic assessment and evaluation of patient satisfaction were performed to evaluate the end result.

RESULTS: At a mean of 9.3 months (range, 6-12 months) after the last session, the overall outcome was rated as excellent improvement (i.e., clinical obliteration and asymptomatic) in four (28.6%) of 14 patients, good improvement (i.e., substantial improvement in size and symptoms of > 50%) in nine patients (64.3%), or moderate improvement (i.e., significant decrease in size and symptoms of
CONCLUSION: Digital subtraction angiography-guided percutaneous foam sclerotherapy modified with the double-needle technique and the filling-defects technique is an alternative method with favorable short-term results for treating peripheral venous malformations.