European radiology · 2026
Predictors of short-term pain relief after polidocanol foam sclerotherapy for painful venous malformations.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wada Shinji, Mimura Hidefumi, Kobayashi Yusuke, Fujizuka Shinji, Hashimoto Kazuki, Hamaguchi Shingo
Аннотация
OBJECTIVES: To evaluate short-term pain relief and safety provided by polidocanol foam sclerotherapy for painful venous malformations (VMs) and determine imaging and procedural predictors of clinical efficacy.
MATERIALS AND METHODS: From April 2015 to September 2025, this single-center retrospective study included 240 consecutive patients who underwent polidocanol foam sclerotherapy for predominantly peripheral VMs. Among these, 181 patients treated for pain were enrolled. Polidocanol at a 1% or 2% concentration was used according to the treatment period and recorded as a candidate predictor. Pain was evaluated using the visual analog scale (VAS). The primary endpoint was a ≥ 50% VAS reduction 2 months after the initial session. Secondary endpoints included technical success and complications, with predictors analyzed using univariable analysis and multivariable logistic regression.
RESULTS: The cohort comprised 181 patients (116 females and 65 males; mean age, 31.4 ± 16.0 years). Two months after initial treatment, 84% patients demonstrated pain reduction, and 47% achieved a favorable response, with complete pain resolution in 28%. In univariate analysis, a smaller lesion size (≤ 5 cm), lobulated morphology, well-defined margins, good sclerosant stasis, and lower VM types were associated with a favorable response. Multivariate analysis demonstrated that good sclerosant stasis was an independent predictor of a favorable response (odds ratio, 2.44; 95% confidence interval, 1.18-5.18, p = 0.016); polidocanol concentration was not significantly associated with outcomes.
CONCLUSION: Polidocanol foam sclerotherapy provides substantial short-term pain relief with favorable safety in patients with painful VMs, with efficacy driven primarily by lesion hemodynamics and technical stasis.
KEY POINTS: Question Identifying specific lesion- and technique-related predictors of short-term pain relief after polidocanol foam sclerotherapy for painful VMs remains an important unmet clinical need. Findings Multivariable analysis identified good sclerosant stasis as the sole independent predictor of a favorable clinical response, overriding baseline characteristics. Clinical relevance Polidocanol foam sclerotherapy safely relieves pain in VMs. To maximize efficacy, clinicians should support a stasis-first treatment strategy, prioritizing optimal intralesional stasis and management of outflow patterns.
MATERIALS AND METHODS: From April 2015 to September 2025, this single-center retrospective study included 240 consecutive patients who underwent polidocanol foam sclerotherapy for predominantly peripheral VMs. Among these, 181 patients treated for pain were enrolled. Polidocanol at a 1% or 2% concentration was used according to the treatment period and recorded as a candidate predictor. Pain was evaluated using the visual analog scale (VAS). The primary endpoint was a ≥ 50% VAS reduction 2 months after the initial session. Secondary endpoints included technical success and complications, with predictors analyzed using univariable analysis and multivariable logistic regression.
RESULTS: The cohort comprised 181 patients (116 females and 65 males; mean age, 31.4 ± 16.0 years). Two months after initial treatment, 84% patients demonstrated pain reduction, and 47% achieved a favorable response, with complete pain resolution in 28%. In univariate analysis, a smaller lesion size (≤ 5 cm), lobulated morphology, well-defined margins, good sclerosant stasis, and lower VM types were associated with a favorable response. Multivariate analysis demonstrated that good sclerosant stasis was an independent predictor of a favorable response (odds ratio, 2.44; 95% confidence interval, 1.18-5.18, p = 0.016); polidocanol concentration was not significantly associated with outcomes.
CONCLUSION: Polidocanol foam sclerotherapy provides substantial short-term pain relief with favorable safety in patients with painful VMs, with efficacy driven primarily by lesion hemodynamics and technical stasis.
KEY POINTS: Question Identifying specific lesion- and technique-related predictors of short-term pain relief after polidocanol foam sclerotherapy for painful VMs remains an important unmet clinical need. Findings Multivariable analysis identified good sclerosant stasis as the sole independent predictor of a favorable clinical response, overriding baseline characteristics. Clinical relevance Polidocanol foam sclerotherapy safely relieves pain in VMs. To maximize efficacy, clinicians should support a stasis-first treatment strategy, prioritizing optimal intralesional stasis and management of outflow patterns.