Tags

Type your tag names separated by a space and hit enter

Clinicoradiologic predictors of sclerotherapy response in low-flow vascular malformations.
J Vasc Surg Venous Lymphat Disord. 2020 Jul 08 [Online ahead of print]JV

Abstract

OBJECTIVE

To evaluate the clinical effectiveness of sclerotherapy agents in low-flow-vascular malformations (LFVM) and identify clinical/imaging features to predict response.

METHODS

A retrospective analysis of hospital records of symptomatic LFVM patients who underwent phlebosclerotherapy from January 2015 to April 2018 was done. Patients were subdivided into venous malformations (VM) and lymphatic malformations (LM). Out of 246 cases, 223 patients (132 males, 91 females; age range, 2-52 years) had VM and 23 (13 males, 10 females; age range, 3 months to 45 years) had LM. The clinical response was graded as excellent (>60%), good (30%-60%), and poor (<30%). More than 30% was considered as acceptable response. The χ2 test was performed for correlation between clinical response and clinical, sonographic, magnetic resonance imaging, phlebographic parameters followed by multilinear regression.

RESULTS

Cavitary (43%) and spongy (37.7%) were the most common phlebographic patterns seen among VM and a cavitary pattern (87%) was most frequent in LM. Sodium tetradecyl sulphate and bleomycin were most commonly used sclerosants in VM and LM, respectively. The mean number of sessions was 4.35 (range, 1-23) in VM and 2.64 (range, 2-7) in LM. Among VM, 114 patients (51.1%) had excellent response to treatment (>60%) and 75.8% patients had an acceptable response (>30%). All patients with LM had an acceptable response (excellent response in 86.9%). Clinical disfigurement, discoloration, diffuse involvement, dysplastic venous morphology on phlebogram, and late and indirect draining vein correlated with poor response to sclerotherapy in VM (P = .003, P = .036, P = .007, P = .008, P = .003, and P = .035, respectively). Cystic components on ultrasound examination and direct draining vein were seen more often in excellent responders (P = .004 and P = .007) in addition to absence of disfigurement, discoloration, and diffuse involvement (P = .032, P = .003, and P = .002). Mod els comprising clinical disfigurement, dysplastic veins, and late draining vein had the greatest predictive value for poor response (R2 = 0.256). Also, the best model for predicting excellent response comprised presence of direct draining vein and absence of skin discoloration (R2 = 0.109). Eleven instances of minor complications occurred among a total of 1032 sessions, seven with sodium tetradecyl sulphate and four with polidocanol.

CONCLUSIONS

Acceptable response to sclerotherapy was achieved in majority of LFVM with extremely low complication rates. Clinicoradiologic features, especially phlebographic findings, correlated with response to sclerotherapy.

Authors+Show Affiliations

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India. Electronic address: ankurgoyalaiims@gmail.com.Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi, India.Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.Department of Plastic Surgery, All India Institute of Medical Sciences, New Delhi, India.Department of Oto-Rhino-Laryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32653406

Citation

Bagga, Barun, et al. "Clinicoradiologic Predictors of Sclerotherapy Response in Low-flow Vascular Malformations." Journal of Vascular Surgery. Venous and Lymphatic Disorders, 2020.
Bagga B, Goyal A, Das A, et al. Clinicoradiologic predictors of sclerotherapy response in low-flow vascular malformations. J Vasc Surg Venous Lymphat Disord. 2020.
Bagga, B., Goyal, A., Das, A., Bhalla, A. S., Kandasamy, D., Singhal, M., & Kairo, A. (2020). Clinicoradiologic predictors of sclerotherapy response in low-flow vascular malformations. Journal of Vascular Surgery. Venous and Lymphatic Disorders. https://doi.org/10.1016/j.jvsv.2020.03.011
Bagga B, et al. Clinicoradiologic Predictors of Sclerotherapy Response in Low-flow Vascular Malformations. J Vasc Surg Venous Lymphat Disord. 2020 Jul 8; PubMed PMID: 32653406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinicoradiologic predictors of sclerotherapy response in low-flow vascular malformations. AU - Bagga,Barun, AU - Goyal,Ankur, AU - Das,Abanti, AU - Bhalla,Ashu Seith, AU - Kandasamy,Devasenathipathy, AU - Singhal,Maneesh, AU - Kairo,Arvind, Y1 - 2020/07/08/ PY - 2019/12/27/received PY - 2020/03/19/accepted PY - 2020/7/13/entrez PY - 2020/7/13/pubmed PY - 2020/7/13/medline KW - Low-flow vascular malformations KW - Lymphatic malformations KW - Phlebography KW - Sclerotherapy KW - Venous malformations JF - Journal of vascular surgery. Venous and lymphatic disorders JO - J Vasc Surg Venous Lymphat Disord N2 - OBJECTIVE: To evaluate the clinical effectiveness of sclerotherapy agents in low-flow-vascular malformations (LFVM) and identify clinical/imaging features to predict response. METHODS: A retrospective analysis of hospital records of symptomatic LFVM patients who underwent phlebosclerotherapy from January 2015 to April 2018 was done. Patients were subdivided into venous malformations (VM) and lymphatic malformations (LM). Out of 246 cases, 223 patients (132 males, 91 females; age range, 2-52 years) had VM and 23 (13 males, 10 females; age range, 3 months to 45 years) had LM. The clinical response was graded as excellent (>60%), good (30%-60%), and poor (<30%). More than 30% was considered as acceptable response. The χ2 test was performed for correlation between clinical response and clinical, sonographic, magnetic resonance imaging, phlebographic parameters followed by multilinear regression. RESULTS: Cavitary (43%) and spongy (37.7%) were the most common phlebographic patterns seen among VM and a cavitary pattern (87%) was most frequent in LM. Sodium tetradecyl sulphate and bleomycin were most commonly used sclerosants in VM and LM, respectively. The mean number of sessions was 4.35 (range, 1-23) in VM and 2.64 (range, 2-7) in LM. Among VM, 114 patients (51.1%) had excellent response to treatment (>60%) and 75.8% patients had an acceptable response (>30%). All patients with LM had an acceptable response (excellent response in 86.9%). Clinical disfigurement, discoloration, diffuse involvement, dysplastic venous morphology on phlebogram, and late and indirect draining vein correlated with poor response to sclerotherapy in VM (P = .003, P = .036, P = .007, P = .008, P = .003, and P = .035, respectively). Cystic components on ultrasound examination and direct draining vein were seen more often in excellent responders (P = .004 and P = .007) in addition to absence of disfigurement, discoloration, and diffuse involvement (P = .032, P = .003, and P = .002). Mod els comprising clinical disfigurement, dysplastic veins, and late draining vein had the greatest predictive value for poor response (R2 = 0.256). Also, the best model for predicting excellent response comprised presence of direct draining vein and absence of skin discoloration (R2 = 0.109). Eleven instances of minor complications occurred among a total of 1032 sessions, seven with sodium tetradecyl sulphate and four with polidocanol. CONCLUSIONS: Acceptable response to sclerotherapy was achieved in majority of LFVM with extremely low complication rates. Clinicoradiologic features, especially phlebographic findings, correlated with response to sclerotherapy. SN - 2213-3348 UR - https://www.unboundmedicine.com/medline/citation/32653406/Clinicoradiologic_predictors_of_sclerotherapy_response_in_low-flow_vascular_malformations L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-333X(20)30202-X DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.