Sclerotherapy is a type of treatment that involves the injection of a special chemical into the venous malformation to ultimately shrink it and relieve the symptoms it is causing. Various substances can be used but most commonly the chemical used is Sodium Tetradecyl sulphate (Fibrovein). When injected into a lesion it causes an inflammatory reaction which leads to localised blood clots and the formation of a scar in place of the venous malformation. This corresponds to shrinkage of the malformation. This is carried out under ultrasound and x-ray control as the doctor needs to be sure that the correct part of the malformation is accessed with the needle and needs to assess the degree of communication with adjacent communicating veins.
Percutaneous ablation is also known as “sclerotherapy”. We may use these terms interchangeably when discussing the treatment of symptomatic vascular malformations.
Congenital Vascular Malformations (CVM) occur in about 1% of all births and can vary from simple, flat birthmarks to complex, 3-dimensional structures deep within the body. They can be made up of arteries, veins, lymph vessels, or a combination of these. They are usually present at birth, but are unlikely to be passed on from parent to child or for there to be more than one in any given person.
Treatment of a CVM involves the use of a needle or catheter to inject medical grade alcohol into the malformation to embolize (obstruct) the flow of blood. Embolization can be used to shrink a large CVM to make it easier to be operated on. In some cases, surgery may be avoided altogether. Sometimes the treatment requires several stages to fully eradicate the entire malformation. The specific procedure will depend on the type of CMV you have:
Transcatheter Embolization: AVMs are typically treated by inserting a catheter into the artery that leads to the malformation. Particles, glue, coils, and a variety of agents may be injected to treat an AVM.
Percutaneous Ablation: Venous and lymphatic malformations are generally treated by inserting a needle directly into the malformation and injecting medical grade alcohol or a similar agent into them to get them to shrink down and perhaps go away altogether.