Digital subtraction angiography-guided ethanol sclerotherapy for peripheral venous malformation: A retrospective cohort study of single centre experience

ABSTRACT Introduction: Venous malformations are the most common type of vascular malformations. Ethanol sclerotherapy is one of the most commonly used treatment methods. This study is to evaluate the initial results of digital subtraction angiography-guided ethanol sclerotherapy in patients with peripheral venous malformation. Methods: This was a retrospective cohort study of a single centre experience. Patients diagnosed with peripheral venous malformation who underwent digital subtraction angiography-guided ethanol sclerotherapy from Jan 2017 to Jun 2021 were included in the study. Medical records were reviewed to record demographic information, lesion characteristics including clinical and magnetic resonance imaging findings, treatment sessions, therapeutic outcomes, and complications. Results: A total of 104 patients were included. The mean number of procedures was 2.0 ± 1.3 times. Last follow-ups revealed a partial relief of symptoms in 97.2% of patients, and three patient (2.9%) showed no improvement. Post-treatment imaging revealed an overall objective response rate of 93.3%. Early post-procedural minor complications occurred after sclerotherapies in 31.7% of patients and were entirely resolved by conservative means. On multivariate analysis, poorly-defined margin (OR: 10.7, 95% CI: 2.28–76.9) and volume of venous malformation on MRI (OR: 1.04, 95% CI: 1.00–1.11) were independent predictors of “no-good response” to percutaneous ethanol sclerotherapy. Conclusion: Percutaneous sclerotherapy is safe and effective in the treatment of venous malformation. A poor-defined margin and volume of VMs on MRI were statistically significant predictors of the initial percutaneous ethanol sclerotherapy results and may be useful in selecting patients. Highlights