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Percutaneous Treatment of Peripheral Vascular Malformations in Children: Long-Term Clinical Outcome

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Abstract

Purpose

This study was designed to assess the rate of complications and clinical failure at 3 and 12 months after percutaneous treatment of vascular malformations in children. Furthermore, we describe patient satisfaction of treatment results during 5 years of follow-up.

Methods

In a retrospective cohort study, we evaluated 26 patients younger than aged 19 years who were treated for symptomatic vascular malformations. Data on treatment outcomes and patient satisfactions were obtained with a precoded structured questionnaire. Patient files and imaging data were retrieved to obtain information regarding the vascular malformations and treatment. Clinical success was defined as disappearance or partial improvement of the complaints. Patient satisfaction was declared whenever patients answered in the questionnaire that they were satisfied with the treatment results.

Results

Of 26 eligible patients, we included 23 (88%). The mean follow-up was 36 (range, 15–127) months. Posttreatment, 87% (20/23; 95% confidence interval (CI), 66–97%) of patients reported clinical success at 3 months. At 1, 2, 3, 4, and 5 years of follow-up this percentage was 74%, 59%, 59%, 59%, and 59%, respectively. Eleven (48%, 95% CI 27–69%) patients had experienced complications and 22% (95% CI 7–44%) had major complications, of which 5 had required additional treatment. In all, 83% (19/23) of the patients reported satisfaction with the treatment.

Conclusions

Percutaneous treatment of vascular malformations improved clinical symptoms in 87% of the patients at 3 months and were sustainable for half of all patients during a 5-year follow-up period. However, major complications were seen in 22%.

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References

  1. van Rijswijk CSP, van der Linden E, van der Woude HJ, van Baalen JM, Bloem JL (2002) Value of dynamic contrast-enhanced MR imaging in diagnosis and classifying peripheral vascular malformations. Am J Roentgenol 178:1181–1187

    Google Scholar 

  2. Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69:412–422

    Article  PubMed  CAS  Google Scholar 

  3. Cohen JM, Weinreb JC, Redman HC (1986) Arteriovenous malformations of the extremities: MR imaging. Radiology 18:894–900

    Google Scholar 

  4. Meyer JS, Hoffer FA, Barnes PD, Mulliken JB (1991) Biological classification of soft-tissue vascular anomalies: MR correlation. Am J Roentgenol 157:559–564

    CAS  Google Scholar 

  5. Berenguer B, Burrows PE, Zurakowski D, Mulliken JB (1999) Sclerotherapy of cranial venous malformations: complications and results. Plast Reconstr Surg 104(1):1–11

    Article  PubMed  CAS  Google Scholar 

  6. Uehara S, Osuga K, Yoneda A, Oue T, Yamanaka H, Fukuzawa M (2009) Intralesional sclerotherapy for subcutaneous venous malformations in children. Pediatr Surg Int 25:709–713

    Article  PubMed  Google Scholar 

  7. Yakes WF, Rossi P, Odink H (1996) How I do it: arteriovenous malformation management. Cardiovasc Intervent Radiol 19:65–71

    Article  PubMed  CAS  Google Scholar 

  8. White RI (2000) Long-term outcome of embolotherapy and surgery for high-flow extremity arteriovenous malformations. J Vasc Intervent Radiol 11:1285–1295

    Article  Google Scholar 

  9. Donally LF, Admas DM, Bisset GS III (2000) Vascular malformations and hemangiomas: a practical approach in a multidisciplinary clinic. Am J Roentgenol 174:597–608

    Google Scholar 

  10. Yakes WF, Haas DK, Parker SH et al (1989) Symptomatic vascular malformations: ethanol embolotherapy. Radiology 170:1059–1066

    PubMed  CAS  Google Scholar 

  11. Gorriz E, Carreira JM, Reyes R et al (1998) Intramuscular low-flow vascular malformations: treatment by means of direct percutaneous embolization. Eur J Radiol 28:161–165

    Article  Google Scholar 

  12. Do YS, Yakes WF, Shin SW et al (2005) Ethanol embolization of arteriovenous malformations: interim results. Radiology 235:674–682

    Article  PubMed  Google Scholar 

  13. van der Linden E, Pattynama PM, Heeres BC, de Jong SC, Hop WC, Kroft LJ (2009) Long-term patient satisfaction after percutaneous treatment of peripheral vascular malformations. Radiology 251(3):926–932

    Article  PubMed  Google Scholar 

  14. Yakes WF, Luethke JM, Parker SH et al (1990) Ethanol embolization of vascular malformations. Radiographics 10:787–796

    PubMed  CAS  Google Scholar 

  15. Jackson EJ, Mansfield AO, Allison DJ (1996) Treatment of high-flow vascular malformations by venous embolization aided by flow occlusion techniques. Cardiovasc Intervent Radiol 19:323–328

    Article  PubMed  CAS  Google Scholar 

  16. Omary RA, Bettmann MA, Cardella JF et al (2003) Quality improvement for the reporting and archiving of interventional radiology procedures. Society of Interventional Radiology Standards of Practice Committee. J Vasc Interv Radiol 14(Suppl):S293–S295

    Article  PubMed  Google Scholar 

  17. Mendonca DA, McCafferty I, Nishikawa H, Lester R (2010) Venous malformations of the limbs: the Birmingham experience, comparisons and classification in children. J Plast Reconstr Aesthet Surg 63(3):383–389

    Article  PubMed  Google Scholar 

  18. Goyal M, Causer PA, Armstrong D (2002) Venous vascular malformations in pediatric patients: comparison of results of alcohol sclerotherapy with proposed MR imaging classification. Radiology 223(3):639–644

    Article  PubMed  Google Scholar 

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There are no potential conflicts of interest of the authors.

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Correspondence to Edwin van der Linden.

Additional information

Addendum: manuscript is submitted on behalf of the Working Group Vascular malformations Rotterdam (WEVAR); A.P. Oranje, G. Madern, P. de Laat, and P.T.M. Patynamma.

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van der Linden, E., Otoide-Vree, M. & Pattynama, P.M.T. Percutaneous Treatment of Peripheral Vascular Malformations in Children: Long-Term Clinical Outcome. Cardiovasc Intervent Radiol 35, 316–324 (2012). https://doi.org/10.1007/s00270-011-0170-6

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  • DOI: https://doi.org/10.1007/s00270-011-0170-6

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