Role of sclerotherapy in vascular malformations

Summary

Congenital vascular malformations (CVM) are a heterogeneous group of vessels defects that include venous, lymphatic, arteriovenous and combined anomalies. CVM may be located in every part of the body with great variability. A precise diagnostic process is required to get complete information about the anomaly prior to decide treatment between different options: surgery, sclerotherapy, embolization and laser. Sclerotherapy has a role in each type of CVM. However, correct indication, selection of the best sclerosing agent, and knowledge of technical skills in CVM are required for a good result. In venous malformations, ethanol is the most effective sclerosing agent but experience in management is required. Lymphatic malformations, mainly in the macrocystic form, can be treated easily with different substances. The nidus of arteriovenous malformations can be occluded by alcohol sclerosis. However, because of the high hemodynamic of AVM, treatment may be difficult; a good sclerosing technique is necessary to avoid complications and to get good results, which are always possible.

Zusammenfassung

Kongenitale vaskuläre Malformationen (CVM) sind eine heterogene Gruppe von Gefäßerkrankungen die venöse, lymphatische, arteriovenöse und kombinierte Anomalien einschließen. CVM können in jeder Körperregion vorkommen mit großer Variabilität. Ein genauer Diagnoseprozess ist notwendig, um alle Informationen über die Anomalie vorab zu erhalten, um über zwischen den verschiedenen Behandlungsoptionen zu entscheiden: Operation, Sklerotherapie, Embolisation und Laser. Sklerotherapie spielt eine Rolle bei jeder Art von CVM. Jedoch sind eine korrekte Indikation, die Auswahl des besten sklerosierenden Agens und die technischen Fähigkeiten bei der CVM unerlässlich für gute Resultate. Bei venösen Malformationen ist Ethanol das effektivste sklerosierende Agens, aber für dessen Einsatz ist Erfahrung erforderlich. Lymphatische Malformationen, hauptsächlich in makrozystischer Form, können leicht mit anderen Substanzen behandelt werden. Der Nidus arteriovenöser Malformationen (AVM) kann durch Alkoholsklerosierung okkludiert werden. Doch kann durch die große Hämodynamik der AVM die Behandlung schwierig sein, daher ist eine gute Sklerosierungstechnik notwendig, um Komplikationen zu vermeiden und gute Resultate zu erhalten, die immer möglich sind.

Keywords

Sclerotherapy - malformations - CVM - arteriovenous malformations - lymphatic malformations

Schlüsselwörter

Sklerotherapie - Malformationen - CVM - arteriovenöse Malformationen - lymphatische Malformationen

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