SCLEROTHERPAY FOR SLOW FLOW VASCULAR MALFORMATION

What is slow flow vascular malformation:

• Slow flow (venous, lymphatic or mixed) vascular malformations are abnormally developed blood vessels with varying degrees of communication with normal veins. It is NOT A TUMOUR. 
•  It can occur anywhere in the body but commonly found in limbs or head & neck region.

What are the symptoms:

• It is present at birth, but due to small size it may remain unnoticeable.
• Some patients present with pain and swelling later in life. Depending on their location malformations may cause pain, swelling, restriction of movement or cosmetic issues.

Why it is necessary to treat:

• Reasons for treatments includes increase in the size of lesion, bleeding from lesion, becomes painful, restricting limb movement or for cosmetic reason.

How it can be treated:

• Percutaneous Sclerotherapy: 
• It involves injection of a special chemical into the vascular spaces. It leads to shrinkage of vascular channels and relieve the symptoms.
• Various substances can be used but most commonly chemical used is sodium tetradecyl sulphate (Setrol).
• It is carried out under ultrasound and fluro guidance as a day care procedure in hospital. Sclerotherapy is not a “cure” for vascular malformations but it is aimed at controlling symptoms and reducing in size. In some cases, with multiple sessions, it can be cured. 
• Surgery.
• Or a combination of these.

Preparation for procedure:

• Few basic blood investigations like CBC, PT/INR, viral markers.
• Bring all the records including imaging record.
• Signing consent form.

What are risks:

• Vary with site of embolization; Skin ulcer, non-target embolization, infection (<1 case in 1000).