CC-BY-NC-ND 4.0 · J Clin Interv Radiol ISVIR 2018; 02(01): 042-050
DOI: 10.1055/s-0038-1642106
Pictorial Essay
Thieme Medical and Scientific Publishers Private Ltd.

Preoperative Cyanoacrylate Embolization of Venous Malformations

Eric J. Monroe
Section of Interventional Radiology, Department of Radiology, Seattle Children's Hospital and University of Washington, Seattle, Washington, United States
,
Rush Chewning
Division of Vascular and Interventional Radiology, Boston Children's Hospital, Boston, Massachusetts, United States
,
Kevin S. H. Koo
Section of Interventional Radiology, Department of Radiology, Seattle Children's Hospital and University of Washington, Seattle, Washington, United States
,
Giri Shivaram
Section of Interventional Radiology, Department of Radiology, Seattle Children's Hospital and University of Washington, Seattle, Washington, United States
› Author Affiliations
Further Information

Publication History

Received: 16 October 2017

Accepted: 15 December 2017

Publication Date:
03 May 2018 (online)

Abstract

Percutaneous sclerotherapy and standalone surgical excision have historically been the mainstay of treatment for pediatric venous malformations (VMs). However, both approaches have significant limitations. Sclerotherapy often requires multiple treatment sessions, with each round adding additional procedural and anesthetic risks as well as radiation exposure. Standalone surgical excision of VMs can be complicated by high-volume blood loss, and indistinct lesion margins can lead to incomplete resection, resulting in recurrence. An alternative to these approaches is percutaneous cyanoacrylate glue embolization followed by immediate surgical excision, a single-stage procedure that allows for better surgical margin definition and reduced intraoperative blood loss, potentially leading to more definitive treatment. The authors describe the interventional radiology aspects of this combined procedure, emphasizing materials preparation and embolization technique.