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Radio-opaque ethylcellulose-ethanol is a safe and efficient sclerosing agent for venous malformations

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the efficacy and safety of gelified ethanol, a newly developed sclerosing agent for slow-flow vascular malformations.

Methods

Seventy-nine sclerotherapy procedures were performed on 44 patients with 37 venous malformations, 2 glomuvenous malformations, 2 lymphatic malformations, 2 lymphatico-venous malformations, and 1 Klippel-Trenaunay syndrome. The median injected volume was 1.00 mL/site of injection. Effects of sclerotherapy on pain, functional and cosmetic disturbance were statistically evaluated with a final result score. Local and systemic complications were recorded.

Results

The mean Visual Analogue Scores were 5.20 ± 2.81 before and 1.52 ± 1.25 after treatment (p < 0.001). Functional and aesthetic improvement was achieved in 31/35 patients (89%) and in 33/41 (80%), respectively. Minor local side effects included necrosis with or without issue of ethylcellulose, palpable residue, and hematoma. No systemic side-effects occurred.

Conclusion

Per mL used, radio-opaque gelified ethanol is at least as effective as absolute ethanol. No systemic complication was observed, as only a low dose of ethanol was injected. Indications for sclerotherapy can be widened to areas with higher risk for local side effects (hands and periocular region), as ethanol is trapped in the lesion. Careful injection procedure is though necessary, because only a limited amount of ethylcellulose can be used per puncture.

Key Points

• Development of a new sclerosing agent for venous malformations.

• Interesting novel way to deliver alcohol to slow-flow vascular malformations.

• Alcohol-based with less local and systemic side-effects.

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Abbreviations

VM:

Venous malformation

LM:

Lymphatic malformation

LVM:

Lymphatico-venous malformation

GVM:

Glomuvenous malformation

KT:

Klippel-Trenaunay syndrome

VAS:

Visual Analogue pain Score

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Acknowledgments

The authors thank Ms Liliana Niculescu for excellent secretarial assistance. MV is supported by grants from F.R.S-FNRS. All affiliations with or financial involvement, from the conception of the study until the publication of the manuscript with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript are completely disclosed. A patent application on radioopaque ethylcellulose ethanol (PCT/FR2006/002213) was deposited on the 28th of September 2006 by Anne Dompmartin, Daniel Labbé and Jacques Théron. These studies were partially supported by the Interuniversity Attraction Poles initiated by the Belgian Federal Science Policy network 6/05; concerted Research Actions (A.R.C)—Convention N° 07/12-005 of the Belgian French Community Ministry and the F.R.S.-FNRS (Fonds de Recherche scientifique) (to M.V., a “Maître de recherche honoraire du F.R.S.-FNRS”).

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Authors and Affiliations

  1. Department of Dermatology, Université de Caen Basse Normandie, CHU Caen, Av Georges Clémenceau, 14033, Caen, France

    Anne Dompmartin & Marie-Thérèse Barrellier

  2. Clinical Research and Biostatistical Unit, Université de Caen Basse Normandie, CHU Caen, Av Georges Clémenceau, 14033, Caen, France

    Xavier Blaizot, Yannick Chene & Cathy Gaillard

  3. Neuroradiology, Université de Caen Basse Normandie, CHU Caen, Av Georges Clémenceau, 14033, Caen, France

    Jacques Théron

  4. Department of Vascular and Interventional Radiology, Center for Vascular Anomalies, Université Catholique de Louvain, Cliniques Universitaires St Luc, av Hippocrate 10, 1200, Brussels, Belgium

    Frank Hammer

  5. Plastic Surgery, Université de Caen Basse Normandie, CHU Caen, Av Georges Clémenceau, 14033, Caen, France

    Daniel Labbé

  6. Pharmacy Department, Université de Caen Basse Normandie, CHU Caen, Av Georges Clémenceau, 14033, Caen, France

    Robert Leroyer, Valérie Chedru & Catherine Ollivier

  7. Division of Plastic Surgery, Center for Vascular Anomalies, Université Catholique de Louvain, Cliniques Universitaires St Luc, av Hippocrate 10, 1200, Brussels, Belgium

    Laurence M. Boon

  8. Laboratory of Human Molecular Genetics, Université catholique de Louvain, de Duve Institute, av Hippocrate 74, 5th floor, 1200, Brussels, Belgium

    Miikka Vikkula & Laurence M. Boon

Authors
  1. Anne Dompmartin
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  2. Xavier Blaizot
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  3. Jacques Théron
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  4. Frank Hammer
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  7. Marie-Thérèse Barrellier
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  8. Cathy Gaillard
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  9. Robert Leroyer
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  10. Valérie Chedru
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  11. Catherine Ollivier
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  12. Miikka Vikkula
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  13. Laurence M. Boon
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Corresponding author

Correspondence to Laurence M. Boon.

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Dompmartin, A., Blaizot, X., Théron, J. et al. Radio-opaque ethylcellulose-ethanol is a safe and efficient sclerosing agent for venous malformations. Eur Radiol 21, 2647–2656 (2011). https://doi.org/10.1007/s00330-011-2213-4

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  • DOI: https://doi.org/10.1007/s00330-011-2213-4

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