Real-time MRI-guided percutaneous sclerotherapy treatment of venous low-flow malformations in the head and neck

2017 ◽  
Vol 33 (5) ◽  
pp. 344-352 ◽  
Author(s):  
Sasan Partovi ◽  
Ziang Lu ◽  
Lorenna Vidal ◽  
Dean A Nakamoto ◽  
Ji Buethe ◽  
...  
Keyword(s):  
Head And Neck ◽  
Real Time ◽  
Low Flow ◽  
Venous Malformations ◽  
Needle Placement ◽  
Ethanolamine Oleate ◽  
Percutaneous Sclerotherapy ◽  
Institutional Experience ◽  
Mri Guided ◽  
Truefisp Sequence

Purpose This manuscript describes the technique of real-time MRI-guided sclerotherapy for low-flow venous malformations in the head and neck based on our institutional experience. Materials and methods Ethanolamine oleate is used as the sclerosant and is mixed with gadolinium for visualization during the procedure. The five procedural steps include: (I) an initial tri-plane T2-weighted sequence to visualize the lesion; (II) a T1 FSE or trueFISP sequence to assess needle placement and advancement within the lesion; (III) a tri-plane T1 FLASH sequence to monitor sclerosant injection; (IV) a T1 FSE or VIBE sequence to assess sclerosant coverage of the malformation before needle removal; (V) a post-procedural tri-plane T1 fat-saturated sequence to confirm sclerosant coverage of the lesion. Periprocedural medications typically include steroids, antibiotic prophylaxis, and non-steroidal anti-inflammatory medication. Patients are typically admitted for overnight observation. Conclusion Real-time MRI-guided sclerotherapy for low-flow venous malformations in the head and neck is effective and safe.

scholarly journals Real-time MRI guided percutaneous sclerotherapy of low-flow venous malformations

2016 ◽  
Vol 27 (3) ◽  
pp. S290
Author(s):  
S. Partovi ◽  
L. Vidal ◽  
D. Nakamoto ◽  
Z. Lu ◽  
J. Buethe ◽  
...  
Keyword(s):  
Real Time ◽  
Low Flow ◽  
Venous Malformations ◽  
Percutaneous Sclerotherapy ◽  
Mri Guided

Percutaneous sclerotherapy with ethanolamine oleate for venous malformations of the head and neck

2013 ◽  
Vol 6 (9) ◽  
pp. 695-698 ◽  
Author(s):  
Matthew David Alexander ◽  
Ryan A McTaggart ◽  
Omar A Choudhri ◽  
Mary L Marcellus ◽  
Huy M Do
Keyword(s):  
Head And Neck ◽  
Venous Malformations ◽  
Ethanolamine Oleate ◽  
Percutaneous Sclerotherapy

scholarly journals Percutaneous sclerotherapy with gelified ethanol of low-flow vascular malformations of the head and neck region: preliminary results

2019 ◽  
Vol 25 (6) ◽  
pp. 459-464 ◽  
Author(s):  
Anna Maria Ierardi ◽  
◽  
Giacomo Colletti ◽  
Pierpaolo Biondetti ◽  
Margherita Dessy ◽  
...  
Keyword(s):  
Head And Neck ◽  
Vascular Malformations ◽  
Neck Region ◽  
Low Flow ◽  
Head And Neck Region ◽  
Preliminary Results ◽  
Percutaneous Sclerotherapy

scholarly journals Preoperative Epoxy Embolization Facilitates the Safe and Effective Resection of Venous Malformations in the Hand and Forearm

Hand ◽  
2016 ◽  
Vol 12 (4) ◽  
pp. 335-341 ◽  
Author(s):  
Brian P. Holly ◽  
Yuval A. Patel ◽  
James Park ◽  
Laura M. Fayad ◽  
E.Gene Deune ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Standard Of Care ◽  
Low Flow ◽  
Initial Experience ◽  
Venous Malformations ◽  
Functional Impairments ◽  
Intraoperative Bleeding ◽  
Ethylene Vinyl Alcohol ◽  
Percutaneous Sclerotherapy ◽  
Major Procedure

Background: The standard of care for treatment of low-flow venous malformations (VMs) is percutaneous sclerotherapy. These lesions are seldom surgically resected, especially if the malformation is in an anatomically difficult location. Percutaneous sclerotherapy is safe and effective. However, the drawbacks to sclerotherapy are the need for repeated treatments and risks of skin ulceration, deep venous thrombosis, scarring/contractures, and nerve damage. Surgical resection can be difficult because of intraoperative bleeding, intraoperative lesional decompression, and difficulty in localization. Methods: We describe our initial experience with 11 patients who underwent surgical resection of VMs located in the hand and forearm after preembolization of 27 total sites using n-butyl-cyanoacrylate or ethylene vinyl alcohol copolymer. Results: Of the 11 patients treated, 5 had focal VMs, 3 had multifocal VMs, and 3 had diffuse VMs throughout the affected extremity. Four of the 5 patients with focal VMs were followed for at least 1 year, and no further treatment was required. All 3 of the patients with diffuse VMs have required ongoing treatment. No major functional impairments were reported, and there were no major procedure-related complications. Conclusions: Overall, embolization of the malformation before surgical resection facilitated localization, demarcation, and removal of the lesion.

Sign in / Sign up

Export Citation Format

Share Document