Journal of pediatric surgery · 2025
Efficacy, safety and predictive factors for outcomes and adverse events in sclerotherapy for venous malformations in children.
СтатьяНазвание и аннотация: Перевод в очереди
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Schmitt Niclas, Lorenz Julia, Wucherpfennig Lena, Karimian-Jazi Kianush, Ruping Fabian, Ristow Oliver, Hoffmann Jürgen, Günther Patrick, Bendszus Martin, Möhlenbruch Markus A, Vollherbst Dominik F
Аннотация
OBJECTIVES: Percutaneous sclerotherapy is an established treatment for venous malformations (VM), while data on its use in children remain limited. This study aimed to evaluate the efficacy, safety and predictors of clinical outcome and adverse events (AEs) in children undergoing polidocanol-based sclerotherapy of VMs.
METHODS: A retrospective single-center analysis was conducted, including children with VMs treated with polidocanol sclerotherapy. Demographics, clinical, and radiological data were analyzed, and multivariate logistic regression was used to assess the influence of patient- and VM-related factors on clinical outcomes and AEs.
RESULTS: 83 children (182 treatment sessions) were included. Symptom improvement was observed in 54.0 %, while 34.9 % had stable symptoms and 11.1 % reported worsening (mean follow-up: 0.81 ± 1.22 years). The overall AE rate was 13.3 %, with mild but permanent sequela in 3.6 %. Multivariate analysis identified VMs of the extremities as a significant predictor for AEs (p < 0.01; complication rate: 12.0 % versus 1.2 % in other locations). No factor influencing clinical outcome was found (p = 0.11). We observed clinical improvement in most cases (54.0 %), despite a mean VM size increase of 7.76 ± 33.64 % after polidocanol-based sclerotherapy.
CONCLUSION: Polidocanol-based sclerotherapy is an effective and safe treatment option for pediatric VMs. Complications are more common in VMs of the extremities due to higher mobility and hypostatic pressure. Notably, despite therapeutic size reduction is often limited, clinical improvement, such as pain relief, can often be achieved, which needs to be considered for treatment planning.
METHODS: A retrospective single-center analysis was conducted, including children with VMs treated with polidocanol sclerotherapy. Demographics, clinical, and radiological data were analyzed, and multivariate logistic regression was used to assess the influence of patient- and VM-related factors on clinical outcomes and AEs.
RESULTS: 83 children (182 treatment sessions) were included. Symptom improvement was observed in 54.0 %, while 34.9 % had stable symptoms and 11.1 % reported worsening (mean follow-up: 0.81 ± 1.22 years). The overall AE rate was 13.3 %, with mild but permanent sequela in 3.6 %. Multivariate analysis identified VMs of the extremities as a significant predictor for AEs (p < 0.01; complication rate: 12.0 % versus 1.2 % in other locations). No factor influencing clinical outcome was found (p = 0.11). We observed clinical improvement in most cases (54.0 %), despite a mean VM size increase of 7.76 ± 33.64 % after polidocanol-based sclerotherapy.
CONCLUSION: Polidocanol-based sclerotherapy is an effective and safe treatment option for pediatric VMs. Complications are more common in VMs of the extremities due to higher mobility and hypostatic pressure. Notably, despite therapeutic size reduction is often limited, clinical improvement, such as pain relief, can often be achieved, which needs to be considered for treatment planning.