Preclinical Research Of The Treatment On Intractable Venous Malformations With The Polypropylene Suture Embeding And Sclerosing Foam Injecting Into The Veins

Objective: To investigate the effect and related mechanism of intravenous thrombosis formed by embeding the Polypropylene suture into the rabbit’sauricular vein,and the preliminary clinical efficiency of it combined with lauromacrogol sclerosing foam in the treatment of intractable venous malformations.Methods: In this study,3-0 Polypropylene suture was chosen to be embeded into the vein cavity to form thrombosis and fibrosis in the lumen through a simple puncture operation,resulting in permanent occlusion of the vena cavity.In animal experiments part,36 New Zealand white rabbits(72 rabbit’s auricular vein)were randomly divided into A/B/C groups(each 24 cases),0.2ml sclerosing foam was injected into the rabbit’s auricular vein of A group,4 cm 3-0 Polypropylene suture was embedded into the rabbit’s auricular vein of B group,4 cm 3-0Polypropylene suture was embedded and then 0.2ml sclerosing foam was injectedinto the rabbit’s auricular vein of C group.The 4 animals of each group were respectively sacrificed in the 3,10,30 days after the operation,HE stain of vascular pathology specimens were derived from rabbits.Then the degree of vascular endothelial injury,vascular embolism,thrombus organizations of the pathological was observed and scored under the optical microscope.The scores of pathological specimens were measured and analyzed with SPSS22.0software,Rank-sum test was used for comparison between groups,P < 0.05 was considered statistically significant.In clinical experiments,Under the ultrasonic guidance,two volunteers of intractable venous malformation patients were treated by embeding the Polypropylene suture and injecting the sclerosing foam into the malformed vascular cavity,and then recording the length of Polypropylene suture and the dosage of sclerosing foam.Two months later,the patients were followed-up to record the complications and Magnetic Resonance Imaging was performed to assess the effect of the treatment,it’s depend on the assessment whether the treatment should be continued.Results: In animal experiments : in the A group,the scores of vascular endothelial injury on the 3rd day were higher than that on the10 th and 30 th day,the scores of vascular embolism on the 10 th day were higher than that on the 3rd and30 th day,the difference was statistically significance(P<0.05).However,on the3 rd,10th and 30 th day,there is no thrombus organizations occurred in the A group.In the B group,the scores of vascular endothelial injury on the 3rd day were lower than that on the 10 th and 30 th day,the scores of vascular embolism and thrombus organizations on the 30 th day were higher than that on the 3rd and 10 th day,the difference was statistically significance(P<0.05).In the C group,the scores of vascular endothelial injury and vascular embolism on the 3rd day were lower than that on the 10 th and 30 th day,the scores of thrombus organizations on the 30 th day were higher than that on the 3rd and 10 th day,the difference was statistically significance(P<0.05).On the 30 th day,the scores of vascular endothelial injury,vascular embolism,thrombus organizations in the C group were higher than that in the A group,the difference was statistically significance(P<0.05).On the 30 th day,the scores of thrombus organizations in the C group were higher than that in the B group,the difference was statistically significance(P<0.05).In clinical experiments:Two intractable venous malformation patients were treated for 2 and 3times respectively.Two months after the last treatment,the Magnetic Resonance Imaging of the two patients all showed that the lesions were more than 85%smaller than before,and the patients’ subjective satisfaction was good.No serious complications occurred after the treatment.Conclusion: The effect of intravenous thrombosis formed by combining embeding the Polypropylene suture with injecting sclerosing foam into the rabbit’s auricular vein is better than the monotherapy,it’s a new safe,effective,simple and minimally invasive treatment for the intractable venous malformation patients.