Effect Observation Of Foam Sclerotherapy Of Polyoxyethylene Lauryl Ether For Peripheral Venous Malformations

Objective:Venous malformations (VM) is a subclass of the congenital malformations. They are usually noted at birth, unlike hemangiomas, they do not have a cycle growth and subsequent spontaneous regression. They grow proportionately with the child, and to a lesser degree during adulthood, and should be treated conservatively. Traditionally, surgery has been the main treatment for venous malformations. However, incomplete surgical resections often result in recurrence, lead to loss of motor function, nerve damage, and massive bleeding. For this reason, sclerothrapy has been advocated as the common choice of treatment for venous malformations. Traditional sclerosants have the disadvantage that they are liquids, which means that it is difficult to control the dosage of sclerosing liquids because of the progressive dilution and irregular distribution in the vessels. The development of sclerosants in foam form resolve the contradiction. In recent years, Many studies report about the better efficacy of foam sclerotherapy for the venous malformations. Sodium tetradecyl sulfate and Polidocanol are the widely used detergen sclerosants for foam in Europe, However, these are not obtainable in China. Polyoxyethylene Lauryl Ether(Lauromacrogol) is a new sclerosant which is produced in our country, has been reported for using in the form of foam. The objective of this study is to evaluate the efficacy and safety of domestic lauromacrogol as a new foam sclerosant in the treatment of venous malformations.Methods:Between september2010and november2011,15patients(seven male and eight female; ranging from9months and50years) with venous malformations at Shandong Provincial Hospital burn and plastic surgery were enrolled in the study. All the patients were treated with foam sclerotherapy. Sclerosing foam was produced using Tessari method to mix1%lauromacrogol with room air in a1:4ratio. The dosage was determined by the size of the lesion and the age of the patients. The injection of the foam sclerosant may be repeated every4weeks. Therapeutic outcomes and safety were established by evaluating size of lesion, symptom, duration of treatment and side-effects of treatment before and after treatment.Results:A total of48treatment sessions were performed (mean,3.2sessions per patient; range,1～5sessions); All patients were followed up for3months to15months with an average of6.6months. Among the15patients, the results were excellent in5patients, good in8patients, and fair in2patients. Complications were skin blister in one patient. No major complications such as pulmonary thrombosis and stroke were observed.Conclusions:1、The effect of lauromacrogol foam sclerosant in the treatment of venous malformations was considerable. No anaphylaxis or any drug-related complications occurred.2、Foam sclerotherapy as a new sclerotherapy stragety is a safe and effective method for the treatment of patient with venous malformations.