Complications of sclerotherapy for 75 head and neck venous malformations

Eur Arch Otorhinolaryngol. 2016 Apr;273(4):1027-36. doi: 10.1007/s00405-015-3577-x. Epub 2015 Mar 4.

Abstract

Sclerotherapy is one treatment option for head and neck venous malformations (VMs). Evaluation of complication risks is, however, essential to improve its safety. We aimed to systematically report sclerotherapy complications by means of the Clavien-Dindo classification and to distinguish factors predisposing to complications. We identified our institution's head and neck VM patients who received sclerotherapy between 1 January 2007 and 31 August 2013, analyzed patient reports retrospectively, and applied to them the Clavien-Dindo classification. Our 75 VM patients underwent a total of 150 sclerotherapy sessions. The most common sclerosants were 3 % sodium tetradecyl sulfate and polidocanol. Complications occurred in 13 patients (17.3 %) and in 15 sessions (10.0 %); 3 complications required extensive postprocedural treatment and caused permanent morbidity, whereas 12 received conservative treatment. Patients with sclerotherapy complications underwent more treatments (p = 0.009) and more often needed further surgery (p = 0.007). We thus consider sclerotherapy a relatively safe treatment modality for head and neck VMs. To avoid complications, evaluation of VM characteristics and optimal treatment technique in a multidisciplinary team is vital.

Keywords: Clavien-Dindo classification; Safety; Treatment; Vascular anomaly.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Finland
  • Head / blood supply*
  • Humans
  • Male
  • Neck / blood supply*
  • Polidocanol
  • Polyethylene Glycols* / administration & dosage
  • Polyethylene Glycols* / adverse effects
  • Retrospective Studies
  • Sclerosing Solutions / administration & dosage
  • Sclerosing Solutions / adverse effects
  • Sclerotherapy / methods*
  • Sodium Tetradecyl Sulfate* / administration & dosage
  • Sodium Tetradecyl Sulfate* / adverse effects
  • Treatment Outcome
  • Vascular Malformations* / diagnosis
  • Vascular Malformations* / therapy
  • Veins* / abnormalities
  • Veins* / drug effects

Substances

  • Sclerosing Solutions
  • Polidocanol
  • Polyethylene Glycols
  • Sodium Tetradecyl Sulfate