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
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
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
Cohen JM, Weinreb JC, Redman HC (1986) Arteriovenous malformations of the extremities: MR imaging. Radiology 18:894–900
Meyer JS, Hoffer FA, Barnes PD, Mulliken JB (1991) Biological classification of soft-tissue vascular anomalies: MR correlation. Am J Roentgenol 157:559–564
Berenguer B, Burrows PE, Zurakowski D, Mulliken JB (1999) Sclerotherapy of cranial venous malformations: complications and results. Plast Reconstr Surg 104(1):1–11
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
Yakes WF, Rossi P, Odink H (1996) How I do it: arteriovenous malformation management. Cardiovasc Intervent Radiol 19:65–71
White RI (2000) Long-term outcome of embolotherapy and surgery for high-flow extremity arteriovenous malformations. J Vasc Intervent Radiol 11:1285–1295
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
Yakes WF, Haas DK, Parker SH et al (1989) Symptomatic vascular malformations: ethanol embolotherapy. Radiology 170:1059–1066
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
Do YS, Yakes WF, Shin SW et al (2005) Ethanol embolization of arteriovenous malformations: interim results. Radiology 235:674–682
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
Yakes WF, Luethke JM, Parker SH et al (1990) Ethanol embolization of vascular malformations. Radiographics 10:787–796
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
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
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
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
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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