Sclerotherapy of Vascular Malformations

  • Mark W. Stalder
  • Chad A. Perlyn
  • Guilherme DabusEmail author


Advances in interventional techniques have revolutionized the treatment of congenital vascular malformations of all types. Traditional open surgical extirpation of these lesions carries the very real risks of excessive blood loss, incomplete excision of the lesions—often resulting in recurrent pathology—wound-healing complications, and frequently suboptimal aesthetic outcomes. While surgery is still indicated in some cases, interventional treatments have far and away become the first-line approach in a nearly universal paradigm shift toward less invasive techniques that also typically result in diminished associated morbidity.


  1. 1.
    Love Z, Hsu DP. Low-flow vascular malformations of the head and neck: clinicopathology and image guided therapy. J Neurointerv Surg. 2012;4(6):414–25.CrossRefPubMedGoogle Scholar
  2. 2.
    Berenguer B, Burrows PE, Zurakowski D, Mulliken JB. Sclerotherapy of craniofacial venous malformations: complications and results. Plast Reconstr Surg. 1999;104(1):1–11. Discussion 2–5.CrossRefPubMedGoogle Scholar
  3. 3.
    Mason KP, Michna E, Zurakowski D, Koka BV, Burrows PE. Serum ethanol levels in children and adults after ethanol embolization or sclerotherapy for vascular anomalies. Radiology. 2000;217(1):127–32.CrossRefPubMedGoogle Scholar
  4. 4.
    Lee BB, Do YS, Byun HS, Choo IW, Kim DI, Huh SH. Advanced management of venous malformation with ethanol sclerotherapy: mid-term results. J Vasc Surg. 2003;37(3):533–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Sainsbury DC, Kessell G, Fall AJ, Hampton FJ, Guhan A, Muir T. Intralesional bleomycin injection treatment for vascular birthmarks: a 5-year experience at a single United Kingdom unit. Plast Reconstr Surg. 2011;127(5):2031–44.CrossRefPubMedGoogle Scholar
  6. 6.
    Spence J, Krings T, terBrugge KG, da Costa LB, Agid R. Percutaneous sclerotherapy for facial venous malformations: subjective clinical and objective MR imaging follow-up results. AJNR Am J Neuroradiol. 2010;31(5):955–60.CrossRefPubMedGoogle Scholar
  7. 7.
    Spence J, Krings T, TerBrugge KG, Agid R. Percutaneous treatment of facial venous malformations: a matched comparison of alcohol and bleomycin sclerotherapy. Head Neck. 2011;33(1):125–30.CrossRefPubMedGoogle Scholar
  8. 8.
    Tan KT, Kirby J, Rajan DK, Hayeems E, Beecroft JR, Simons ME. Percutaneous sodium tetradecyl sulfate sclerotherapy for peripheral venous vascular malformations: a single-center experience. J Vasc Interv Radiol. 2007;18(3):343–51.CrossRefPubMedGoogle Scholar
  9. 9.
    O’Donovan JC, Donaldson JS, Morello FP, Pensler JM, Vogelzang RL, Bauer B. Symptomatic hemangiomas and venous malformations in infants, children, and young adults: treatment with percutaneous injection of sodium tetradecyl sulfate. AJR Am J Roentgenol. 1997;169(3):723–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Tieu DD, Ghodke BV, Vo NJ, Perkins JA. Single-stage excision of localized head and neck venous malformations using preoperative glue embolization. Otolaryngol Head Neck Surg. 2013;148(4):678–84.CrossRefPubMedGoogle Scholar
  11. 11.
    Mazoyer E, Enjolras O, Laurian C, Houdart E, Drouet L. Coagulation abnormalities associated with extensive venous malformations of the limbs: differentiation from Kasabach-Merritt syndrome. Clin Lab Haematol. 2002;24:243–51.CrossRefPubMedGoogle Scholar
  12. 12.
    Mazoyer E, Enjolras O, Bisdorff A, Perdu J, Wassef M, Drouet L. Coagulation disorders in patients with venous malformations of the limbs and trunk. Arch Dermatol. 2008;144(7):861–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Dompmartin A, Acher A, Thibon P, et al. Association of localized intravascular coagulopathy with venous malformations. Arch Dermatol. 2008;144(7):873–7.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Burrows PE, Mitri RK, Alomari A, et al. Percutaneous sclerotherapy of lymphatic malformations with doxycycline. Lymphat Res Biol. 2008;6(3–4):209–16.CrossRefPubMedGoogle Scholar
  15. 15.
    Nehra D, Jacobson L, Barnes P, Mallory B, Albanese CT, Sylvester KG. Doxycycline sclerotherapy as primary treatment of head and neck lymphatic malformations in children. J Pediatr Surg. 2008;43(3):451–60.CrossRefPubMedGoogle Scholar
  16. 16.
    Acevedo JL, Shah RK, Brietzke SE. Nonsurgical therapies for lymphangiomas: a systematic review. Otolaryngol Head Neck Surg. 2008;138(4):418–24.CrossRefPubMedGoogle Scholar
  17. 17.
    Do YS, Yakes WF, Shin SW, et al. Ethanol embolization of arteriovenous malformations: interim results. Radiology. 2005;235(2):674–82.CrossRefPubMedGoogle Scholar
  18. 18.
    Lee BB, Baumgartner I, Berlien HP, et al. Consensus document of the International Union of Angiology (IUA)-2013. Current concept on the management of arterio-venous management. Int Angiol. 2013;32(1):9–36.PubMedGoogle Scholar
  19. 19.
    Yakes WF, Rossi P, Odink H. How I do it. Arteriovenous malformation management. Cardiovasc Intervent Radiol. 1996;19(2):65–71.CrossRefPubMedGoogle Scholar
  20. 20.
    Yakes WF. Endovascular management of high-flow arteriovenous malformations. Semin Intervent Radiol. 2004;21(1):49–58.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Thiex R, Wu I, Mulliken JB, Greene AK, Rahbar R, Orbach DB. Safety and clinical efficacy of onyx for embolization of extracranial head and neck vascular anomalies. AJNR Am J Neuroradiol. 2011;32(6):1082–6.CrossRefPubMedGoogle Scholar
  22. 22.
    Pekkola J, Lappalainen K, Vuola P, Klockars T, Salminen P, Pitkaranta A. Head and neck arteriovenous malformations: results of ethanol sclerotherapy. AJNR Am J Neuroradiol. 2013;34(1):198–204.CrossRefPubMedGoogle Scholar
  23. 23.
    Benndorf G, Campi A, Hell B, Holzle F, Lund J, Bier J. Endovascular management of a bleeding mandibular arteriovenous malformation by transfemoral venous embolization with NBCA. AJNR Am J Neuroradiol. 2001;22(2):359–62.PubMedGoogle Scholar
  24. 24.
    Fan XD, Su LX, Zheng JW, Zheng LZ, Zhang ZY. Ethanol embolization of arteriovenous malformations of the mandible. AJNR Am J Neuroradiol. 2009;30(6):1178–83.CrossRefPubMedGoogle Scholar
  25. 25.
    Zheng LZ, Fan XD, Zheng JW, Su LX. Ethanol embolization of auricular arteriovenous malformations: preliminary results of 17 cases. AJNR Am J Neuroradiol. 2009;30(9):1679–84.CrossRefPubMedGoogle Scholar
  26. 26.
    Clarencon F, Blanc R, Lin CJ, et al. Combined endovascular and surgical approach for the treatment of palpebral arteriovenous malformations: experience of a single center. AJNR Am J Neuroradiol. 2012;33(1):148–53.CrossRefPubMedGoogle Scholar
  27. 27.
    Arat A, Cil BE, Vargel I, et al. Embolization of high-flow craniofacial vascular malformations with onyx. AJNR Am J Neuroradiol. 2007;28:1409–14.CrossRefPubMedGoogle Scholar
  28. 28.
    Zheng LZ, Fan XD, Zheng JW, Su LX. AJNR Am J Neuroradiol. 2009;30(9):1679–84. doi: 10.3174/ajnr.A1687. Epub 2009 Jul 17Google Scholar
  29. 29.
    Dabus G, Linfante I, Benenati J, Perlyn CA, Martínez-Galdámez M. Interventional management of high-flow craniofacial vascular malformations: a database analysis and review of the literature. J Neurointerv Surg. 2017;9(1):92–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mark W. Stalder
    • 1
  • Chad A. Perlyn
    • 1
    • 2
  • Guilherme Dabus
    • 2
    • 3
    Email author
  1. 1.Department of Plastic and Reconstructive SurgeryNicklaus Children’s HospitalMiamiUSA
  2. 2.Wertheim College of MedicineFlorida International UniversityMiamiUSA
  3. 3.Miami Cardiac and Vascular Institute and Baptist Neuroscience CenterMiamiUSA

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