Frontiers in pediatrics · 2026
Venous malformation with localized intravascular coagulopathy in children treated with sclerotherapy and LWMH.
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Gao Xiao, Wang Xuming, Wei Yuhua, Niu Shuai, Yang Le, Xu Lei
Аннотация
INTRODUCTION: Localized intravascular coagulopathy (LIC) is a common, underrecognized coagulation complication of pediatric venous malformations (VMs), driven by chronic thrombogenic activation within VM lesions. Developmental hemostatic traits in children may exacerbate LIC severity, but clinical characteristics and optimal management of pediatric LIC remain poorly defined.
METHODS: This retrospective cohort study included 116 pediatric VM patients with complete laboratory test results who underwent sclerotherapy at Shandong Provincial Hospital between August 2018 and August 2025. LIC was defined as D-dimer ≥0.60 μg/ml. Chi-square test, Fisher's exact test, Mann-Whitney U test, and correlation analysis were used to explore factors associated with LIC occurrence and severity.
RESULTS: Of 116 patients, 51 (44.8%) had LIC (38 mild, 11 moderate, 2 severe). No significant association was found between LIC (occurrence or severity) and sex, age, or anatomic location. All severe LIC cases occurred in extensive VMs involving ≥2 joint planes. Sclerotherapy combined with low-molecular-weight heparin (LMWH) rapidly corrected coagulation abnormalities in severe LIC.
DISCUSSION: LIC occurrence in pediatric VMs is independent of demographic or anatomic factors, while severity correlates directly with lesion burden. Sclerotherapy is the core intervention for LIC control, with LMWH serving only as perioperative adjuvant therapy. This study supports routine screening for occult VM in unexplained pediatric coagulopathy, providing real-world evidence for optimized clinical management.
METHODS: This retrospective cohort study included 116 pediatric VM patients with complete laboratory test results who underwent sclerotherapy at Shandong Provincial Hospital between August 2018 and August 2025. LIC was defined as D-dimer ≥0.60 μg/ml. Chi-square test, Fisher's exact test, Mann-Whitney U test, and correlation analysis were used to explore factors associated with LIC occurrence and severity.
RESULTS: Of 116 patients, 51 (44.8%) had LIC (38 mild, 11 moderate, 2 severe). No significant association was found between LIC (occurrence or severity) and sex, age, or anatomic location. All severe LIC cases occurred in extensive VMs involving ≥2 joint planes. Sclerotherapy combined with low-molecular-weight heparin (LMWH) rapidly corrected coagulation abnormalities in severe LIC.
DISCUSSION: LIC occurrence in pediatric VMs is independent of demographic or anatomic factors, while severity correlates directly with lesion burden. Sclerotherapy is the core intervention for LIC control, with LMWH serving only as perioperative adjuvant therapy. This study supports routine screening for occult VM in unexplained pediatric coagulopathy, providing real-world evidence for optimized clinical management.