Ethanol Sclerotherapy Research Articles

The Effectiveness of Ultrasound-Guided Percutaneous Aspiration of Simple Renal Cysts in Hospitals of Aljouf Region, Saudi Arabia

Background: Percutaneous renal cyst aspiration and sclero-therapy are considered as single, a safe and minimally invasive procedure currently practicing by numerous uro-surgeons currently in the treatment of simple symptomatic cysts. Objectives: This study was designed to assess the effectiveness and complications of ultrasound (US) guided percutaneous aspiration of renal cysts with 99% ethanol as sclerosing material in the treatment of simple symptomatic renal cysts. Methodology: This observational prospective study was done among 42 patients who had a total of 47 symptomatic simple renal cysts. It was carried out during the period from 2014 to 2017 in the Outpatient Clinic of MOH. The patients’ age ranged between 23-62 years including male (19) and females (23). An US guided ablation of renal cyst was done under local anesthesia. After that, an equal volume of contrast medium was injected through the needle into the cyst cavity to delineate the cyst wall. The sterile 99% ethanol, with one fourth of total cyst volume was injected into the cyst after complete aspiration of the contrast medium. After that, the ethanol was aspirated, and volume was measured. Results: The complications were minimum including, hematuria in 8 patients (17%), low-grade fever in 7 patients (14.8%) and mild flank pain in 5 (10.6%) patients were observed. During the follow-up after the sclerotherapy, out of 47 cysts, 20 (42.5%) cysts with different sizes showed statistically significant (P < 0.05) complete resolution and not appeared again during the later follow-up sessions. The overall success rate in the current study procedure was 100%. Conclusion: Percutaneous aspiration with a single injection of 99% ethanol sclerotherapy gave a high success rate in the treatment of simple renal cysts with good optimization of sclerosing material and effective aspiration skill of uro-surgeon.

The Effectiveness of Ultrasound-Guided Percutaneous Aspiration of Simple Renal Cysts in Hospitals of Aljouf Region, Saudi Arabia

Background: Percutaneous renal cyst aspiration and sclero-therapy are considered as single, a safe and minimally invasive procedure currently practicing by numerous uro-surgeons currently in the treatment of simple symptomatic cysts. Objectives: This study was designed to assess the effectiveness and complications of ultrasound (US) guided percutaneous aspiration of renal cysts with 99% ethanol as sclerosing material in the treatment of simple symptomatic renal cysts. Methodology: This observational prospective study was done among 42 patients who had a total of 47 symptomatic simple renal cysts. It was carried out during the period from 2014 to 2017 in the Outpatient Clinic of MOH. The patients’ age ranged between 23-62 years including male (19) and females (23). An US guided ablation of renal cyst was done under local anesthesia. After that, an equal volume of contrast medium was injected through the needle into the cyst cavity to delineate the cyst wall. The sterile 99% ethanol, with one fourth of total cyst volume was injected into the cyst after complete aspiration of the contrast medium. After that, the ethanol was aspirated, and volume was measured. Results: The complications were minimum including, hematuria in 8 patients (17%), low-grade fever in 7 patients (14.8%) and mild flank pain in 5 (10.6%) patients were observed. During the follow-up after the sclerotherapy, out of 47 cysts, 20 (42.5%) cysts with different sizes showed statistically significant (P < 0.05) complete resolution and not appeared again during the later follow-up sessions. The overall success rate in the current study procedure was 100%. Conclusion: Percutaneous aspiration with a single injection of 99% ethanol sclerotherapy gave a high success rate in the treatment of simple renal cysts with good optimization of sclerosing material and effective aspiration skill of uro-surgeon.

A Painless and Time-Saving Modified Technique for Simple Renal Cyst Treatment with Single-session Ethanol Sclerotherapy

Percutaneous puncture ethanol sclerotherapy is a simple, effective, minimally invasive, and inexpensive procedure to manage symptomatic simple renal cysts. We modified specific technical aspects to balance certain potential intraprocedural factors for ensuring minimal procedural pain and duration as well as maximal clinical therapeutic effects and evaluated the safety and efficacy of this modified technique. A total of 84 eligible patients underwent computed tomography-guided single-session ethanol sclerotherapy using the conventional (group A) or modified (group B) technique. In group B, the puncture route was modified from tansparenchymal to direct for reducing renal injury, and preinjection of low-dose intracystic lidocaine was used to control distending pain caused by ethanol injections; therefore, greater ethanol volumes could be injected for improving the resistance and contact of ethanol with the cyst wall, precluding the need for patient repositioning multiple times to decrease procedural duration. Visual analog scale score for pain and procedural time were significantly higher in group A than in group B. The complication rate was slightly higher in group A than in group B, but the success rate was comparable between the two groups. These results suggest that the modified technique is painless, time-saving, and injury-reducing and can thus improve medical care.

Percutaneous ethanol injection efficacy in the treatment of benign thyroid nodules. Ten-year follow-up of 254 patients

Introduction and aim: Although percutaneous ethanol sclerotherapy for the treatment of benign thyroid nodules (PEI) has been used for more than 30 years, there are only two studies in thyroid cysts (THCY) and 2 in autonomously functioning nodule (AFN) in which the mean follow-up reaches at least five years, while in the event of non-autonomously functioning solid nodules (NAS), there is not any study with at least 5-year mean follow-up. Our study focuses on the long-term efficacy of PEI in benign thyroid nodules. Method: We analyzed the long-term success of PEI in 254 patients treated for more than 10 years. The success was defined as 50% or greater reduction in nodule volume. In addition, the patient had to remain euthyroid without thyrostatic therapy in AFN. Results: The 10-year success rate was 79.4%, 37.1% and 69.4% in THCY, AFN and NAS, respectively. In 23.3% of unsuccessful PEIs, the failure could be revealed only after 5 years of follow-up. The mean nodule volume at 10-year follow-up related to the initial size was 29.8%, 39.6% and 48.9% in THCY, NAS and AFN, respectively. In THCY, PEI proved to be significantly more effective in older patients while other parameters (size of the nodule, amount of the injected alcohol and the ratio of these) did not correlate significantly with the success rate. Conclusions: Our study which presents the longest follow-up in all 3 types of benign thyroid nodules confirms that PEI has a minimal role in AFN, is recommendable in THCY and might have a role in NAS. The success rate decreases over time which emphasizes the importance of the long-term follow-up in the judgement of PEI. Orv Hetil. 2020; 161(6): 224-231.

Efficacy and Safety of USG-guided 95% Ethanol Sclerotherapy in Solitary Benign Thyroid Cysts

Efficacy and Safety of USG-guided 95% Ethanol Sclerotherapy in Solitary Benign Thyroid Cysts

1576 Preoperative MRI is a Must If You Are Planning Sclerotherapy for Ovarian Endometrioma

Video Objective To evaluate the effect of preoperative MRI before sclerotherapy for ovarian endometrioma. Setting An academic teaching hospital. Interventions Ultrasound-guided aspiration followed by ethanol sclerotherapy was done for premenopausal women who are anticipating pregnancy or who are planning any kind of assisted reproductive technique. With the bladder completely emptied, the cystic lesion is localized using a transvaginal ultrasound. The 18 gauge ovum aspiration needle is penetrated into the cystic cavity under ultrasound guidance. Constant negative pressure is indirectly applied with a syringe. Once the cyst is adequately drained, normal saline is flushed into the cystic cavity for irrigation until the irrigated fluid becomes clear. Then the cystic cavity is irrigated with 95% ethanol and another ethanol is instillated in the cyst. Although variable according to size and duration, the majority of endometrioma present as a classic homogeneous hypoechoic cyst with diffuse ground glass appearance on ultrasound. However, even if preoperative ultrasound strongly suggests endometrioma, differential diagnosis must be made to rule out the possibility of other kind of ovarian cysts like dermoid cyst or mucinous cyst if one is planning sclerotherapy. Magnetic resonance imaging (MRI) is known to have greater specificity for the diagnosis of endometriomas. They appear bright on T1 weighted image due to hemorrhagic contents and will remain bright on T1 fat suppressed images. It shows shading on T2 weighted image secondary to high concentration of protein and degraded blood products. Conclusion We suggest that MRI should be performed in all women in whom sclerotherapy is being considered as a treatment for ovarian endometrioma to rule out other cystic ovarian lesions which might mimic the ultrasound findings of an endometrioma.

Venous Malformations Sclerotherapy: Outcomes, Patient Satisfaction and Predictors of Treatment Success.

To retrospectively evaluate the results of sclerotherapy for venous malformations, with emphasis on patient satisfaction, complications and predictors of positive response to treatment. Three hundred and nine patients were treated with ethanol sclerotherapy for venous malformations in our center between the years 2000 and 2014. All of them were sent a self-assessment questionnaire for evaluation of their satisfaction and treatment complications. In total, 153 patients (mean age 21, range 6weeks to 67years) responded to the questionnaire. We analyzed clinical and imaging data from the medical records of these patients. Sixty-four (42%) patients had venous malformations in the lower extremities, 35 (23%) in head and neck regions, 33 (22%) in the trunk, 14 (9%) in the upper extremities and 5 (3%) in the buttock and genitalia. Complete relief of swelling, pain, functional and esthetic complaints was reported in 23%, 22%, 17% and 12% of patients, respectively. Thirty-eight (25%) patients reported being very satisfied with treatment outcomes, 55 (36%) were satisfied, 49 (32%) were not satisfied and 11 (7%) were very unsatisfied. We did not find significant correlations between patient satisfaction and demographics characteristics, lesion location, lesion size, tissue involvement or total sclerosant quantity. The rate of class 3 complications was 7% and that of class 4 complications was 2%. Ethanol sclerotherapy is an effective treatment for venous malformations. Nonetheless, this treatment has a significant complication rate. Patient satisfaction is independent of lesion characteristics and is not as high as may be expected.

Venous malformation of lower limb with hypertrophy of limb, early terminalization of hair and hyperhidrosis

Vascular anomalies are the commonest developmental disorders. Venous malformations (VM) result due to dysmorphogenesis in the development of veins. Most commonly these disorders are localized to skin and subcutaneous tissue. Deeper venous malformation may affect the underlying muscle, bone and joints. Early terminalization of hair and increased sweating in VM plaque has been rarely reported. The present study deals with the case of a 15-year-old boy who had VM involving skin, subcutaneous tissue and bones with terminal hair and increased sweating over the plaque. Radiological examination showed bone hypertrophy with slow flow channels and phleboliths due to superficial and deep VM. He was treated with ethanol sclerotherapy.

Conservative treatment of neck lymph nodes metastases of well-differentiated thyroid cancer by ethanol sclerotherapy. First results

Мета роботи — оцінити безпечність та ефективність черезшкірної етанолової склеротерапії одиничних метастазів високодиференційованого раку щитоподібної залози в разі пролонгації злоякісного процесу. Матеріали та методи. Проаналізовано резу­ль­тати лікування хворих, яким проведено комбі­­нова­не лікування високодиференційованого раку щи­­топодібної залози (екстрафасціальна тиреоїдектомія, центральна, латеральна дисекція шиї, лімфаденектомія на стороні ураження, з подальшим проведенням радіойодтерапії у дозі від 100 до 150 mCi), у яких була відзначена пролонгація злоякісного процесу з метастатичним процесом у поодиноких лімфовузлах шиї (n = 16), з них — 4 чоловіки, 13 жінок, яким була виконана перкутанна етанолова склеротерапія. Середній вік хворих — 43 роки (min — 17 років; max — 66 років). З початку 2012 року вказаним хворим проведено черезшкірну етанолову деструкцію одиничних метастатичних лімфовузлів шиї. В окремі групи виділені хворі з йод-нечут­ливими пухлинами (низький ТГ, низький АтТГ) та хворі з пухлинами, схильними до низької диференціації (низький ТГ, високий АтТГ). Зважаючи на низьку вибірку, статистичний розрахунок поки не проводився. Ефек­тив­ність методу лікування оцінювалася за динамікою рівня тиреоглобуліну, антитіл до тиреогло­­буліну крові в еутиреозі перед маніпуляцією та через 3, 6 та 12 міс, ультразвукових характеристик ме­­тастатичних лімфатичних вузлів (наявність кровотоку, ехогенність, геометричні роз­­міри та конфігурація), відсутністю ускладнень. Засто­су­­вання такого лікування можливе тільки після ультразвукової та цитологічної верифікації метастатичного ураження лімфатичних вузлів. Про­­цедура ЧЕІ завжди виконувалась одним лі­­карем-радіо­­логом. Жоден па­­цієнт не потребував попередніх анестезіо­­логічних заходів. Ета­нолова склеротерапія ви­­конувалася тіль­­ки в амбулаторних умовах. Ефектив­ність методу лікування оцінювалася за динамікою рівня тиреоглобуліну сироватки крові, антитіл до тиреоглобуліну крові в еутиреозі перед маніпуляцією та через 3, 6 міс та 12 міс, ультразвукових характеристик метастатичних лімфатичних вузлів (наявність кровотоку, ехогенність, гео­­метричні розміри та кон­фігурація), відсутністю ускладнень. Результати та обговорення. На основі проспективного аналізу результатів лікування методика че­­резшкірної етанолової абляції метаста­­тичних лімфовузлів шиї у 13 хворих дала позитив­­ний клініко-лабораторний ефект (зниження рівня тиреоглобуліну в середньому на 34,8 % — з 2,146 ± 5,47 до 0,748 ± 1,75 нг/мл (р < 0,05); антитіл до тиреоглобуліну на 16,4 % — з 11,59 ± 5,32 до 9,69 ± 1,19 IU/мл через 3 міс) та стійку ремісію захворювання, що також підтверджено результатами УЗД шиї (відсутність кровото­­ку, зменшення розмірів вражених лімфатичних вузлів у 6 хворих у середньому на 37,5 %, з 7,0 ± 4 мм до 4,375 ± 2 мм у найбільшому розмірі та за відсутності метастатичного ураження в 7 обстежених хворих). У 2 хворих відзначався ріст метастатичного лім­фовузла з наявним кровотоком, із підвищенням рівня тиреоглобуліну в середньому на 52,7 % з 0,18 нг/мл до 0,38, антитіл до тиреоглобуліну крові на 19,4 %, з 10,00 до 12,39 ± 1,81. У 1 хворого розміри лімфовузла не змінилися, кровоток збере­жений, лабораторні по­­казники — без динаміки. Вказаним 3 хво­­рим виконана повторна склеротерапія. Отри­­мані результати свідчать про високу ефективність описаного методу лікування метастатичної хвороби (позитивний ефект у 77,8 % пролікованих хворих). Висновки. За наявності пролонгації злоякісного процесу етанолова деструкція метастатичних лімфовузлів дозволяє відмовитись від повторного оперативного втручання, що має низький ризик ускладнень та високу економічну доцільність.

The Efficacy of Lymph Node Embolization Using N-Butyl Cyanoacrylate Compared to Ethanol Sclerotherapy in the Management of Symptomatic Lymphorrhea after Pelvic Surgery

PurposeTo compare the efficacy of lymph node (LN) embolization using N-butyl cyanoacrylate versus ethanol sclerotherapy in the management of symptomatic postoperative pelvic lymphorrhea. Materials and MethodsThirty-three patients with 40 instances of symptomatic postoperative lymphorrhea were treated with either LN embolization or sclerotherapy at Seoul National University Hospital from January 2009 to July 2017 and were retrospectively included (LN embolization group: 24 lymphoceles of 19 patients, mean age of 59.29 years; sclerotherapy group: 16 lymphoceles of 14 patients, mean age of 60.95 years). The types of operations were hysterectomy and bilateral oophorectomy with pelvic lymph node dissection (n = 9), radical prostatectomy (n = 3), and renal transplantation (n = 2) for the sclerotherapy group and radical prostatectomy (n = 10) and hysterectomy and bilateral oophorectomy with pelvic lymph node dissection (n = 9) for the LN embolization group. The 3 most common indications of treatment were lower extremity edema (n = 11), pain (n = 11), and fever (n = 8). The amount of leak before treatment (initial daily drainage) and clinical outcomes, including the clinical success rate in 3 weeks, treatment period, and complication rate were compared between both groups. ResultsLN embolization showed a higher 3-week clinical success rate than sclerotherapy in a univariate analysis (83.3% and 43.8%, P = .026). There was no statistically significant difference in the treatment period and the complication rate (7.1 days and 12.3 days, P = .098; 8.3% and 25.0%, P = .184). ConclusionsLN embolization is more effective for treating postoperative pelvic lymphorrhea than sclerotherapy with similar safety.

A Novel Technique in the Treatment of Lymphoceles After Renal Transplantation: C-Arm Cone Beam CT-Guided Percutaneous Embolization of Lymphatic Leakage After Lymphangiography.

We aimed to evaluate the efficacy of percutaneous embolization after lymphangiography using C-arm cone-beam computed tomography (CBCT) performed at the site of lymphatic leakage in patients with postrenal transplant lymphocele. Between July 2014 and August 2017, 13 patients not responding to percutaneous ethanol sclerotherapy and conservative treatment for recurrent lymphocele after renal transplant were included. The mean age of the patients was 56.38 ± 9.91 (range, 36-70) years, and it comprised 9 men and 4 women. All patients underwent intranodal lymphangiography. C-arm CBCT-guided percutaneous embolization was performed in patients with confirmed lymphatic leakage. Patients who had no lymphatic leakage underwent drainage with fibrin glue injection. Lymphatic leakage was observed in 9 patients after lymphangiography, and they underwent CBCT-guided percutaneous N-butyl-2-cyanoacrylate embolization. The volume of lymphatic drainage reduced to less than 10 mL in 8 patients. One patient who was not responding to embolization was treated surgically, after percutaneous drainage and fibrin glue injection. Lymphatic leakage was not observed in 4 patients after lymphangiography. Of these, 3 patients showed a reduction in the amount of lymphatic drainage after lymphangiography. All 4 patients underwent percutaneous drainage and fibrin glue injection. One patient did not respond to the treatment and was treated surgically. Prelymphangiography and postlymphangiography and embolization, the volume of lymphatic drainage was 113.07 ± 21.75 mL, and 53.84 ± 30.96 mL, respectively, and statistically significant decrease was detected (P < 0.005). Lymphangiography and CBCT-guided percutaneous embolization procedures might be an effective treatment method for patients with lymphocele refractory to treatment.

Ethanol sclerotherapy or polidocanol sclerotherapy for symptomatic hepatic cysts.

BackgroundOver the past decades, multiple approaches to aspiration sclerotherapy of large symptomatic hepatic cysts have been investigated. However, comparative data are scarce.ObjectiveThe objective of this article is to compare cyst reduction, symptomatic relief, and adverse events between ethanol sclerotherapy and polidocanol sclerotherapy.MethodsThis retrospective study included adults having a symptomatic hepatic cyst treated at a European tertiary referral center with ethanol sclerotherapy (Center 1) or polidocanol-sclerotherapy (Center 2). We compared cyst diameter reduction (%) and symptom improvement (yes/no) within 12 months’ post-treatment between centers using multivariate regression analyses adjusted for confounding factors. Finally, we compared adverse events using Fisher’s exact test.ResultsWe included 71 patients from Center 1 and 66 patients from Center 2 (median age 57 years; 126/137 (92%) female). Cyst reduction was comparable between Centers 1 and 2: 37.5% (IQR 15.7–61.0%) versus 44.2% (IQR 24.6–60.5%), respectively (p = 0.35). Correspondingly, symptomatic relief was comparable: 30/53 (56.6%) versus 43/66 (65.2%), respectively (p = 0.88). Center 1 reported significantly more (11 versus 3; p = 0.047) adverse events than Center 2.ConclusionWe found comparable cyst reduction and symptomatic relief rates between ethanol- and polidocanol sclerotherapy, while adverse events occurred more often in the ethanol group. Prospective studies focused on clinical response are needed to further explore differences between approaches.

Percutaneous US-guided combined ethanol and tetracycline injection for treating symptomatic simple and hydatid hepatic cysts

IntroductionPercutaneous treatment of simple or hydatid liver cysts is widely used in clinical practice and ethanol is the commonest sclerosant used. Abdominal discomfort and pain commonly occurs after ethanol injection which increase with increased ethanol volume. PurposeTo evaluate the safety and efficacy of the combination of tetracycline and ethanol for percutaneous sclerotherapy of either symptomatic simple hepatic cysts or unilocular hepatic hydatid cysts. Patients and methodsA total of 34 adult patients with symptomatic simple cyst and 36 unilocular hydatid cysts underwent clinical, laboratory and radiological evaluations followed by diagnostic cyst aspiration. Each was divided into 2 arms. The first arm was treated by ethanol sclerotherapy and the second was treated by combined ethanol and tetracycline sclerotherapy. ResultsCombined ethanol and tetracycline sclerotherapy was associated with fewer sessions than ethanol sclerotherapy (P = ≤0.001) and higher rate of sustained cyst size reduction on follow up (P = ≤0.001). Also second arm was associated with less pain than alcohol alone due to the beneficial effect of tetracycline. Conclusion: combined ethanol and tetracycline seems to be more effective, non expensive, more sustained action and more comfortable to our patients than single ethanol use.

Prevention of recurrence of simple renal cyst after retroperitoneal laparoscopic decortication

Objective To investigate the effective method of reducing the recurrence of renal cyst after retroperitoneal laparoscopic decortication. Methods The clinical and follow-up data of 328 cases of patients with simple renal cyst underwent retroperitoneal laparoscopic renal cyst decompression from January 2014 to March 2016 in our hospital were analyzed retrospectively. One hundred and five patients had a simple decortication (control group, n=105). The remaining 223 patients had a decortication with different intervention method to prevent recurrence, including 60 cases with anhydrous ethanol sclerotherapy (sclerotherapy group, n=60), 78 cases with wadding of the cyst using perirenal fat tissue (fat wadding group, n=78 ) and 85 cases with evaginated and fixed the cyst wall by titanium clips (titanium clips fixed group, n=85). The operation time, intraoperative blood loss, postoperative complications, postoperative hospital stay and recurrence rate after 1 year were compared. Results Compared with the control group, all the 3 intervention methods (sclerotherapy group, fat wadding group and titanium clips fixed) significantly decreased the 1 year recurrence rate (5%, 3.8%, 4.7% vs. 13.3%, F=8.319, P=0.040). However, the operation time [(40.7±12.6)min vs. (30.5±10.2)min, t=5.664, P 0.05). Conclusions Combined with wadding of the cyst using perirenal fat tissue or evaginated and fixed the cyst wall by titanium clips in the retroperitoneal laparoscopic decortication is a safe and effective method to reduce postoperative recurrence. The anhydrous ethanol sclerotherapy may be an inappropriate choice due to increased operation time and complications. Key words: Kidney Diseases; Cysts; Laparoscopes; Decompression, Surgical

Abstract No. 704 Single-session 99.5% ethanol sclerotherapy for simple renal cysts: comparison of 40- and 120-minute retention techniques

To compare the results of 40- and 120-minute ethanol sclerotherapies which were performed in a single session for the management of simple renal cysts. We retrospectively reviewed 63 renal cysts in 62 patients treated by single-session percutaneous ethanol sclerotherapy. Thirty-two cysts in 31 patients underwent 40-minute sclerotherapy (group A) and 31 cysts in 31 patients underwent 120-minute retention technique (group B). Under ultrasonographic and fluoroscopic guidance, the cystic fluid was completely aspirated and 50% of the aspirated volume replaced with 99.5% ethanol (maximum, 100 mL). Follow-up of the patients were performed with ultrasonography or computed tomography (CT) at 3 months after sclerotherapy. Overall, technical success rates were 100% in both two groups. Eighteen patients (28.6%) were symptomatic (flank pain or discomfort). Indications of the other patients were large cyst (>5cm; 46%) and increment of the diameter on serial studies (25.4%). There was no significant difference between the two groups in terms of age (62.22 vs. 62.48 years), cyst diameter (8.43 vs. 8.14 cm), volume of aspirated fluid (230.06 vs. 250.16 mL), volume of injected ethanol (77.81 vs. 70.48 mL), and percentage of decrement of cyst diameter (58.6 vs. 53.67%) (P>0.05). After the treatment, flank pain or discomfort resolved in 17 (94.4%) of 18 symptomatic patients. One patient complained persistent flank pain, but no significant abnormality was detected on post-procedural CT images. There were no other complications after therapy in two groups. Single-session ethanol sclerotherapy with 40-minute retention technique is an effective and safe method for the treatment of simple renal cysts. It can reduce the procedural time and length of hospital stay, but there is no statistical difference in therapeutic efficacy between 40- and 120-minute therapies.

Ethanol Sclerotherapy for the Treatment of Uterine Cysts in the Mare

In this article, ethanol sclerotherapy was proposed for the treatment of large uterine cysts in the mare. Eight infertile mares, aged between 13 and 21 years, with large uterine cysts and without other detectable causes of infertility were selected. The cysts were emptied endoscopically, and 70% ethanol in saline solution was injected to fill 40% of the original volume. The mares were monitored clinically and ultrasonographically at 4 hours and at days 1, 3, and 14 after the treatment, as in the following estrus cycles. The cysts, which at diagnosis ranged between 4 and 6 cm in diameter, were between 0 and 0.5 cm after 4 hours and were not detectable in the following evaluations. No side effects or a recurrence of the uterine cyst were recorded. Fertility was recovered in 87.5% of the treated mares. The ethanol sclerotherapy seemed useful and safe to treat uterine cysts in the mare, also when the cysts were not pedunculated.

A Case of Venous Malformation of the Pyriform Sinus Treated with Ethanol Sclerotherapy

We describe a case of venous malformation of pyriform sinus in 63 year-old patient, discovered incidentally. Venous malformation are the most common vascular malformations to arise in the head and neck. However venous malformation of the hypopharynx in the adult papulation are rare. The author performed successfully ethanol sclerotherapy for venous malformation of pyriform sinus, so we present the case with a review of the related literatures. Key words: Pyriform sinus ㆍ Venous malformation ㆍ Ethanol ㆍ Sclerotherapy 핵심용어: 이상와 ㆍ ì •ë§¥ 기형 ㆍ 에탄올 경화요법

Percutaneous Ethanol Sclerotherapy of Venous Malformations of the Oral Cavity and the Oropharynx

Percutaneous Ethanol Sclerotherapy of Venous Malformations of the Oral Cavity and the Oropharynx

332 - Ethanol Sclerotherapy for the Treatment of Ovarian Endometrioma

332 - Ethanol Sclerotherapy for the Treatment of Ovarian Endometrioma

Intralesional Lidocaine Anesthesia: A Novel Facilitated Anesthesia Technique for Ethanol Sclerotherapy of Venous Malformation.

The aim of this study was to describe a novel anesthesia, intralesional lidocaine anesthesia (ILA), for ethanol sclerotherapy of venous malformation and evaluate the efficacy and safety. A prospective study of 100 patients with venous malformations undergoing 100 sclerotherapy procedures with intralesional lidocaine anesthesia (ILA) was conducted. Pain was evaluated by numeric rating scale (NRS) immediately following the procedure. The grade of pain was classified by the NRS as no pain (0), mild (1-3), moderate (4-6), and severe (7-10). Local and systemic complications caused by lidocaine were recorded. The median injected volume of absolute ethanol and 0.25% lidocaine was 5.9 mL and 17.0 mL, respectively. In ILA group, 13 patients had no pain during the procedure, 42 patients had mild pain, 38 patients had moderate pain, and 7 patients had severe pain. The mean NRS scores of the whole ILA group were 3.2 (0-8). No local or systemic complications attributed to lidocaine were reported. In a limited series, intralesional lidocaine anethesia seems to be efficient and safe for use in pain management for ethanol sclerotherapy of venous malformation. This anesthesia technique may be a promising first approach for the ethanol sclerotherapy of venous malformations, as it is easy to handle and has minimal sequelae.