Sclerotherapy Treatment Research Articles

Necrosis of Lower Third Face: Rare Complication Due to Sclerotherapy for Treatment of Labial Vascular Malformation

Necrosis of Lower Third Face: Rare Complication Due to Sclerotherapy for Treatment of Labial Vascular Malformation

Efficacy of Sclerotherapy With Polidocanol (Ethoxysclerol) in Primary Aneurysmal Bone Cysts in Children and Adolescents.

Aneurysmal bone cysts (ABC) are rare benign osseous lesions that can be locally aggressive. Traditionally, curettage with or without bone grafting is the treatment of choice. Recent data suggest that percutaneous sclerotherapy is a safe alternative to surgery. We present our experience with percutaneous sclerotherapy. Primary study aims were success rate, risk factors for treatment failure, and complications. In this single-center retrospective study (January 2003 to June 2019), 70 patients were treated with percutaneous sclerotherapy for primary ABC at various skeletal sites. Median age was 11 years (range: 3 to 17 y). Median follow-up was 40 months (range 18 to 144 mo). Clinical and radiologic assessments were performed until cyst healing. Successful healing was seen in 58 of 70 patients (83%) after 1 or more injections with polidocanol. In 12 patients (17%), definitive curettage was performed after previous sclerotherapy, which was considered failure of primary sclerotherapy treatment. Trends toward increased risk for >3 treatments or treatment failure included age younger than 5, epiphyseal plate involvement, and lower leg lesions. The only complication was anaphylaxis in 1 patient shortly after injection of polidocanol/contrast agent and ropivacaine, with full recovery after short resuscitation. Our results show that percutaneous sclerotherapy with polidocanol has high efficacy in the treatment of primary ABC, with a low complication rate. Our only complication may have been an immediate allergic reaction to polidocanol/contrast agent or ropivacaine. Trends toward increased risk for treatment failure were age younger than 5, epiphyseal plate involvement, and lower leg lesions. Level IV-therapeutic study.

Treatment for bleeding oesophageal varices in people with decompensated liver cirrhosis: a network meta-analysis.

Treatment for bleeding oesophageal varices in people with decompensated liver cirrhosis: a network meta-analysis.

Percutaneous treatments of primary aneurysmal bone cysts: systematic review and meta-analysis.

To systematically review the literature to determine recurrence rates of percutaneous treatments for primary aneurysmal bone cysts (ABC). Search strategies were performed in the following databases: PubMed, SCIELO, LILACS and BVS, using terms in English, Spanish and Portuguese (PROSPERO Registration Number: CRD42020170340). Longitudinal studies, either observational or clinical trials, with at least five patients and with a mean of 18months of follow-up were included. Studies had to use any type of percutaneous treatments and report the recurrence rates of primary ABC treatment. Studies selection, data extraction and risk of bias assessment were performed independently by two researchers. A global meta-analysis was carried out to assess the proportion of recurrence. Studies were categorized into two subgroups: selective arterial embolization and sclerotherapy. Thirteen studies were included in the present study. The average success rate of percutaneous treatments for ABC was 91.11%, with a total of 37 lesions recurrences in the 416 patients. The sex ratio was 1:1. The subgroup of sclerotherapies presented a lower proportion of recurrence. The proportion of recurrence in the subgroup of selective arterial embolization was 19% (95%IC 12.11-27.54) and that of sclerotherapies was 6% (95%IC 3.65-9.19). Both percutaneous treatments for ABC are effective, showing a lower rate of recurrence. Sclerotherapy treatments seem to be promising, but further clinical trials must be conducted with a longer follow-up.

Complex treatment of children with vascular head and neck malformations

The article analyzes the results of treatment of children affected with lesions of blood vessels of the head and neck. The research is aimed at developing and implementing minimally invasive techniques to treat such children. The study group comprised 4416 patients with hyperplasia of blood vessels (the so-called infantile and congenital hemangiomas) and 397 patients with blood vessel malformations, examined and treated from 1991 to 2020. The paper summarizes developed indications and the results of implementation of effective minimally invasive methods for the treatment of children with vascular lesions: radiofrequency thermal ablation and pulsed dye laser treatment of children with severe forms of arterio-venous malformation in their maxillofacial area and. The treatment is currently the golden standard that provides stable aesthetic results. The most optimal and preferred methods of vascular lesions treatment proved to be minimally invasive techniques that include: radiofrequency thermal ablation, interstitial laser coagulation, pulse phototherapy, sclerotherapy and systemic treatment of beta-blockers.

Bilateral foam polidocanol sclerotherapy of great saphenous veins and their tributaries in synchronous procedure.

BackgroundChronic venous insufficiency is a highly prevalent disease. Advanced cases have high morbidity.ObjectivesTo evaluate the risks and benefits of foam sclerotherapy in patients who underwent bilateral treatment of the great saphenous veins in a single procedure, in selected cases of advanced venous insufficiency.MethodsWe retrospectively reviewed 55 patients (110 limbs) with bilateral incompetence of the great saphenous veins who had undergone foam sclerotherapy treatment bilaterally, using a maximum dose of 20 ml of foam per patient and inelastic compression.ResultsIn 81 (73.6%) of the 110 saphenous veins analyzed, occlusion was obtained in the first session. After a second session this figure rose to 106 (96.3%) and all 110 (100%) veins were occluded after three sessions. Bilateral occlusion of the great saphenous veins was achieved in 27 patients (50%) in one session, in 34 (62%) patients in two sessions, and in 55 (100%) patients in three sessions. At 42 days after sclerotherapy, there was complete ulcer healing in seven (63%) of the 11 patients with ulcers and partial healing in 3 (27%) of these patients. One patient (1.8%) had self-limited lipothymia and visual scotomas, 3 patients (5.45%) had skin spots, and 19 patients (34.5%) developed retained intravascular coagulum.ConclusionsBilateral foam sclerotherapy in a synchronous procedure is an option to be considered for treatment of varicose veins of the lower limbs.

Surgical treatment of vulvar venous malformations without preoperative sclerotherapy: Outcomes of 18 patients

BackgroundOur aim was to evaluate the benefit of surgical resection of the venous malformations (VMs) of the external female genitalia. MethodsOver the period of 2009–2019, 18 consecutive females underwent surgical resection for vulvar VM. Evaluations included preoperative Doppler ultrasound, MRI, and pre-and postoperative photographic imaging. The main outcomes were: residual pain, cosmetic distortion, residual VM, and quality of life. ResultsOver a 10 year periods, 18 females, mean age 35 years (range 9–71) were included in this study. All patients were symptomatic: 16 had intermittent pain or discomfort, 1 had bleeding and 2 requested cosmetic treatment. Of these cases, there were 5 isolated vulvar VM, 12 associated VM: 3 of the clitoral hood, 3 troncular pelvic vein insufficiency and 12 of the lower limb. Eight patients had undergone previous procedures: 2 sclerotherapy treatments (1–3 sessions), 4 partial surgical resections.There were 18 single resections in the vulva (7 focal, 11 complete), 2 partial resections in clitoral hood and 2 had resection of a VM in the perirtoneovaginal canal at the same time. The mean follow-up was 42. 9 months (range 6–120). Two patients were lost to followup at 6 months. For all patients, elimination of pain and soft tissue redundancy was achieved. Two patients had persistent discomfort and 2 requested cosmetic treatment. ConclusionSurgical resection of vulvar VM can be the best approach with few postoperative complications, good functional and cosmetic results. Appropriate preoperative evaluation is required to identify isolated VM or VM associated with ovarian vein or internal iliac vein insufficiency requiring to be treated before surgery.

Qualitative evaluation of MRI features in aneurysmal bone cysts after percutaneous sclerotherapy.

To report MRI findings of changes seen in aneurysmal bone cysts after percutaneous sclerotherapy treatment. After applying exclusion criteria, a total of 36 patients who had aneurysmal bone cysts and undergone percutaneous sclerotherapy were included in this study. The pre-treatment and post-treatment MRIs were reviewed and multiple pre-determined MRI findings were evaluated. The presence of each post-treatment finding, as well as the time for each finding to develop, was recorded. Early post-sclerotherapy changes include increased perilesional edema and enhancement, which appear on MRI on average 5.1months after the initial sclerotherapy. This is followed by decreased cystic areas, which can be seen on average 5.9months after the initial treatment. The presence of fibrosis, improved cortical integrity, and improving mass effect are later post-treatment changes and appear on MRI on average 9.7months, 10.6months, and 16.1months after the initial sclerotherapy, respectively. The early and late post-sclerotherapy MR findings of aneurysmal bone cysts were reported in this study.

Imaging assessment and treatment of soft-tissue venous malformations: Retrospective case series study of 126 cases.

Venous malformations (VMs) are common slow-flow vascular malformations, which affect almost anywhere of the body. From January 2010 to October 2019, 126 patients with VMs who had complete imaging and follow-up data were enrolled into this study, including 75 males. The initial treatment age ranged from 5 to 72 years. The role of imaging results on the choice of treatment measures and the application were summarized. In this study, we retrospectively analyzed the imaging examinations, treatment measures, and follow-up results of the patients with VMs in our clinic. In this series, imaging examinations included ultrasound, magnetic resonance imaging, computed tomography (CT) scan and enhanced scan, percutaneous sinus angiography and three-dimensional CT imaging, plain film, CT venography, CT angiography, and digital subtraction angiography. Treatment measures included surgical excision (n = 20), sclerotherapy (n = 86, including absolute ethanol [n = 75], polidocanol [n = 8], and pingyangmycin [n = 3]), and combination treatment with intralesional copper wire retention and sclerotherapy(n = 20). After treatment, most of the lesions shrunk obviously or disappeared, and the symptoms were largely relieved. Comprehensive and accurate imaging assessment of VMs is necessary for selecting appropriate treatment. Individual strategy and sequential treatment can achieve effective results and avoid potential complications.

SCLEROTHERAPY WITH 5% MONOETHANOLIN OLEATE IN ORAL VASCULAR MALFORMATIONS WITH AESTHETIC IMPLICATIONS

Objective: To describe the effect of sclerotherapy treatment in oral vascular malformations (OVMs) with aesthetic complaints. Study design: A retrospective, descriptive study of 6 years through analysis of medical records. Epidemiologic data, clinical aspects of OVMs before, during, and after sclerotherapy with 5% monoethanolamine oleate (MO) and diagnostic resources were collected. Results: There were 19 individuals with 21 low-flow OVMs treated with MO. All patients presented complaints of unsatisfactory aesthetic results at the first exam and only 2 (10.5%) presented with actual symptomatology. The female sex was the most prevalent (68%), with a mean age of 64 years. The lower lip (52.3%) was the most affected region. Doppler ultrasonography was performed in 6 (31.5%) individuals with vascular lesions greater than 5 mm. In most cases, 1 (38.1%) or 2 (38.1%) sclerotherapy sessions were sufficient for obtaining satisfactory results. All patients complained of local burning during the application of MO, however, during follow-up, they did not present any complaints of pain or aesthetic problems. Conclusion: It was possible to obtain satisfactory aesthetic results in low flow MVs with few sessions of sclerotherapy with 5% MO that can be well tolerated for the patients. Objective: To describe the effect of sclerotherapy treatment in oral vascular malformations (OVMs) with aesthetic complaints. Study design: A retrospective, descriptive study of 6 years through analysis of medical records. Epidemiologic data, clinical aspects of OVMs before, during, and after sclerotherapy with 5% monoethanolamine oleate (MO) and diagnostic resources were collected. Results: There were 19 individuals with 21 low-flow OVMs treated with MO. All patients presented complaints of unsatisfactory aesthetic results at the first exam and only 2 (10.5%) presented with actual symptomatology. The female sex was the most prevalent (68%), with a mean age of 64 years. The lower lip (52.3%) was the most affected region. Doppler ultrasonography was performed in 6 (31.5%) individuals with vascular lesions greater than 5 mm. In most cases, 1 (38.1%) or 2 (38.1%) sclerotherapy sessions were sufficient for obtaining satisfactory results. All patients complained of local burning during the application of MO, however, during follow-up, they did not present any complaints of pain or aesthetic problems. Conclusion: It was possible to obtain satisfactory aesthetic results in low flow MVs with few sessions of sclerotherapy with 5% MO that can be well tolerated for the patients.

Efficacy of foam sclerotherapy in treatment of grade I and grade II bleeding hemorrhoids at Nalanda Medical College and Hospital, Patna

Background: Sclerotherapy is the treatment of choice for first and second grade haemorrhoidal disease. The aim of this study is to assess the efficacy and safety of polidocanol foam for haemorrhoidal disease.Methods: A total of 50 patients were treated with foam sclerotherapy (polidocanol 3%). Patients who presented with complain of bleeding per anum and diagnosed with first and second grade hemorrhoidal disease were included. Patients without bleeding per anum were not included. The primary objective was the stopping of perianal bleeding after one sclerotherapy session. Sclerotherapy was repeated at 2-week intervals until patients were free of bleeding. The final follow-up was 12 weeks after the last sclerotherapy session.Results: After one foam sclerotherapy session, 82% of patients (41 out of 50) were treated successfully. After second sclerotherapy, 98% of the patients (46 out of 50) were treated successfully. 2% of the patients received third sclerotherapy.Conclusions: In the treatment of first and second grade haemorrhoidal disease, polidocanol 3% foam is very effective and safe. The results of this study show that foam sclerotherapy is a new, innovative, effective and safe non-surgical treatment option for haemorrhoidal disease.

Reducing hyperpigmentation after sclerotherapy: A randomized clinical trial

ObjectiveSclerotherapy for the treatment of varicose veins is one of the most common medical procedures performed in the Western world, and hyperpigmentation is one of the most frequent, dreaded, minor adverse events. There has recently been some interest in investigating the inflammatory response of the local endothelium after sclerotherapy and the possible benefits of venoactive drugs because of their pleiotropic properties. The aim of this study was to evaluate whether adding a venoactive drug (sulodexide) to the standard sclerotherapy treatment protocol for patients with varicose veins can reduce the occurrence of postsclerotherapy hyperpigmentation. MethodsWe carried out a prospective, multicenter, randomized controlled trial with a parallel group design. It included 720 patients with telangiectasia, reticular veins, or varicose veins who were candidates for sclerotherapy. Patients with reflux in deep system or saphenous veins were excluded. Group A consisted of 354 patients who received an oral dose of sulodexide twice a day for 7 days before scheduled sclerotherapy; the treatment then continued for 3 months. Group B consisted of 366 patients who received the standard sclerotherapy protocol. Polidocanol was used as the sclerosing agent, and 20 to 30 mm Hg compression stockings were used in both groups for 7 days. Control photographs were taken, and a follow-up examination took place after 1 month and 3 months. Computer software was used to analyze the treated area for incidence of hyperpigmentation, total area of hyperpigmentation, skin tone increase in the hyperpigmented area, vein disappearance, and incidence of major bleeding. The sample size was calculated to give a statistical power of 80%. Student t-test and the χ2 test were used for comparative analyses, as appropriate. The level of significance was set at P < .05. ResultsA total of 609 patients completed the 3-month follow-up: 312 in group A and 297 in group B. After 1 month, the incidence of hyperpigmentation was 8.7% in group A and 14.8% in group B (P = .01). Group A developed an average area of hyperpigmentation of 10.7% compared with 18.2% in group B (P = .01), and the skin tone of the hyperpigmented area was lower in group A than in group B (P = .02). However, the latter difference was not significant after 3 months. The overall vein disappearance rate was similar in both groups. ConclusionsOur analysis shows that by adding a venoactive drug (sulodexide) to the standard sclerotherapy protocol, the occurrence of hyperpigmentation is reduced without affecting the desired therapeutic vein elimination response.

Polidocanol versus phenol in oil injection sclerotherapy in treatment of internal hemorrhoids: A randomized controlled trial.

Management of Haemorrhoids is suboptimal and is largely based on traditional practices in the Indian population. Though injection sclerotherapy is a well-accepted treatment modality in early grade haemorrhoids, there is no consensus on the effectiveness of the drugs used for sclerotherapy. The study was done to compare the safety and efficacy of a standard sclerosant (polidocanol) and the conventionally used phenol in oil in bleeding grade-1 and 2 internal haemorrhoids. All patients with grade-1 and 2 hemorrhoids, were selected and randomised into two groups, 3% polidocanol and 5% phenol group. All patients were followed-up for three months and observed for "free of bleeding" or "persistent bleeding." Pain, pruritus and patient satisfaction following the procedure was also assessed. A total of 150 patients were enrolled, 75 in each group. At the end of the first sclerotherapy session with polidocanol, 60.6% of patients versus 38.1% in phenol group had stopped per rectal bleeding (p=0.009). After the second sclerotherapy session, 94.7% of patients in the polidocanol group and 84% of patients in the phenol group were treated successfully. Polidocanol group required significantly fewer treatment sessions than the phenol group (1.39±0.49 vs. 1.62±0.49; p=0.035), and the total volume of injected sclerosant was also less (3.30±0.96 mL vs. 4.86±1.46 mL; p=0.001). The patient satisfaction was 87% in polidocanol group versus 73% in phenol group (p=0.040). 3% polidocanol is safe and more effective than 5% phenol in oil when used as injection sclerotherapy in the treatment of first and second-degree internal hemorrhoids.

Haemangioma of the Penis: A Review and Update of the Literature

Haemangioma of the penis (HOP) is a rare benign vascular lesion which can affect the penis of males including infants, children, and adults of up to the over 80 year-olds. HOP does manifest as: asymptomatic lump or lesion on the penis; localised pain or tenderness anywhere within the penis; a tumoral mass anywhere on the penis; pain in the penis on erection; curvature of penis on erection; bright red compressible papule or papules on penis; nodules on penis; plaques on penis; ulceration on penis; haemorrhage on penis. HOP may be associated erectile dysfunction in some cases and could affect voiding if it is associated with the urethral meatus. HOP which tends to be solitary in most cases may mimic other diseases of the penis as well as may be associated with haemangioma in the scrotum and perineal region occasionally. Diagnosis can be established by the clinical features and this can be reaffirmed by radiology imaging features with the use of Doppler ultrasound scan, CT scan and MRI scan which show low-flow within the lesion. Majority of the lesions tend to be superficial and not associated with the corpora cavernosa and spongiosum. There is no consensus opinion on the best treatment options hence various treatment options for HOP have been successfully utilized including: complete surgical excision, sclerotherapy, laser treatment, cryotherapy, and other therapies. Most cases of HOP do not recur but following sclerotherapy and laser treatment of large HOPs repeat procedures tend to be required and there may be residual / recurrent lesion that may need to be treated again. Deep and large HOPs may require complete excision with insertion of tunica graft. Very large HOPs could be more effectively treated by one stage complete surgical excision but the choice of the patient is important. The diagnosis of the lesion can be confirmed by the histopathology features of the lesion and positive immunohistochemistry staining for CD31 (strong), Factor VIII, and HHF35 (myopericytes) and minimal staining for CD34. HOP needs to be carefully differentiated from epithelioid angiosarcoma of the penis and epithelioid haemangioendothelioma. A multi-centre trial of various treatment options for HOP would be required to provide treatment guidelines for HOP taking into consideration the size of the lesion and availability of the various treatment options.

A Comparative Study to Evaluate Early Postoperative Complications and Short-Term Quality of Life Assessment Between Stripping and Endovenous Laser Therapy in the Treatment of Chronic Venous Insufficiency Patients: A Study From North India

Introduction: Most common cause of chronic venous insufficiency (CVI) is Great saphenous vein (GSV)followed by short saphenous vein (SSV) insufficiency. Various modalities for the treatment of CVI areEndovenous thermal (by laser or radiofrequency) ablation, Foam sclerotherapy and Ligation and strippingof GSV.Endovenous thermal therapy is costly for the patients residing in the developing country. Herewith wehave compared quality of life and early complications between ligation and stripping (L & S) of GSV andEndovenous laser therapy (EVLT).Method: Patients of CVI were diagnosed clinically and radiologically by duplex doppler USG. Fifteenpatients in group 1(L & S) and 22 patients in Group 2 (EVLT) were followed at the 6 weeks, 3 months and6 months.Early post procedural outcomes were documented at one week. Generic health was assessed by SF 36tools and Specific health was assessed by Aberdeen varicose vein questionnaires (AVVQ) at baseline(preprocedural), at 6 weeks,3 months and at 6 months.Results: Postoperative pain in group 1 and group 2 patients were in 20.0% and 04.5% patientsrespectively(p>0.05). Paresthesia was in 26.7% and 9.1% respectively (p >0.05). Skin hyperpigmentationwas 00.00% and 4.5% respectively (p 0.403). In both groups, infection was found in 20.0% and 04.5%respectively (p 0.137). Tract haematoma along GSV was in 13.3% and 0.00% respectively in both groups.Physical function, role limitation due to physical problems and emotional problems, emotional well-being,social function, pain, general health at end of 6 weeks and at end of 6 months were slightly better in EVLTpatients but was insignificant (p >0.05). DVT and recurrence were absent in both groups.Conclusion: Regarding treatment of CVI, Early post-operative complications, Short term General anddisease specific QoL is slightly better in patients having EVLT than L & S, but is statistically insignificant.

Safety and effectiveness of percutaneous sclerotherapy for venous disorders of the labia majora in patients with vascular malformations

ObjectiveThe aim of this study was to evaluate the safety and clinical outcomes of percutaneous sclerotherapy of venous disorders of the labia majora in patients with vascular malformations of the lower limbs. MethodsThirty percutaneous sclerotherapy treatments were performed over a 6-year period among 17 female patients with symptomatic venous malformation (VM) or secondary varicosis of the labia majora. Four patients were treated with sclerotherapy alone, 13 patients had additional procedures to control the VM before sclerotherapy. Polidocanol was used as sclerosant. Indications for sclerotherapy included pain, bleeding, thrombophlebitis, and swelling. Genitourinary symptoms were recorded. The number of treatments and procedure-related complications were registered. Complications were classified according to the Society of Interventional Radiology (SIR) classification system (grade A-E). The 3-month postintervention follow-up included magnetic resonance imaging, clinical examination, and a symptom-related questionnaire. If no reintervention was necessary, consultation was scheduled biannually. ResultsAll patients had local swelling and pain; only a fraction of the patients had further symptoms with bleeding or thrombophlebitis (47% each). Eight patients required reintervention. No major complications were observed; minor complications such as postprocedural swelling occurred in 29% (SIR grade A), pain occurred in 17% (SIR grade B), and skin blistering developed in 5% (SIR grade B). Upon follow-up examination after a median of 40 months, 76% showed complete relief of symptoms, and 23% reported partial relief. All patients reported a substantial reduction in pain (75% >5 points in visual analogue scale) and swelling (88% complete cessation). ConclusionsPercutaneous sclerotherapy is a safe and effective treatment option of VM and secondary varicosis of the labia majora.

State of the art on cryo-laser cryo-sclerotherapy in lower limb venous aesthetic treatment

Here we describe a combination of neodymium:yttrium-aluminium-garnet 1064-nm laser emission and injection of 75% dextrose solution to treat lower limb reticular veins. The strategy is known as cryo-laser cryo-sclerotherapy. Preliminary outcomes are reported, showing ecchymosis in up to 30% of cases and intravenous thrombus in 14%. A satisfactory vessel elimination is found in 86% of cases. No improvement or worsening was reported in 14% of patients. The paper provides technical details with the aim of promoting homogeneity in future data collection, so fostering publication of long-term effectiveness and related comparative evaluation with sclerotherapy and laser treatment alone.

4:12 PM Abstract No. 116 Safety of high-dose 3% sodium tetradecyl sulfate for sclerotherapy treatment of renal cysts in autosomal dominant polycystic kidney disease: a five-year study

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease and is a frequent cause for dialysis. Large, central renal cysts are thought to be especially detrimental due to local mass effect resulting in obstruction to blood and urine flow. Over the last five years we have performed cyst sclerotherapy using 3% sodium tetradecyl sulfate (STS). Food and Drug Administration approved dosage of STS is ≤10 mL; however, this relates to its on-label intravascular use. The aim of this study is to assess the safety profile of high-dose (>10 mL) 3% STS sclerotherapy for the treatment of renal cysts in ADPKD. A retrospective analysis of patients diagnosed with ADPKD at the Hereditary Kidney Disease Clinic, Toronto who had undergone percutaneous renal cyst sclerotherapy was performed. Patients treated between August 2014 to August 2019 were included. Patients were divided into groups who received treatments that utilized >10 mL of STS (high-dose) and ≤10 mL STS (low-dose). MRI was used to determine the volume of the targeted kidney(s). Electronic patient records were reviewed for complications. Currently, data for 107 sclerotherapy procedures in patients (mean age, 52.4 years) who have undergone renal sclerotherapy up until August 2017 has been analyzed (high-dose STS = 62; low-dose STS = 45). Mean length of follow-up was 15.4 months. Target kidney volume decrease as measured on MRI was greater in patients who received high-dose STS (high-dose STS = 387 CC, low-dose STS = 178 CC; P <0.05). There was no statistically significant difference between the two groups in terms of total adverse events (high-dose STS = 14, low-dose STS = 5); however, post procedure pain was more frequent in patients receiving high-dose STS group (high-dose STS = 9, low-dose STS = 1 P <0.05). No major complications occurred. High intracystic doses of STS are associated with more effective cyst volume reduction but no apparent increase risk of adverse events apart from postprocedural pain.

Sclerotherapy With OK-432 for the Treatment of Symptomatic Lymphocele After Lymph Node Dissection: A Retrospective Comparative Cohort Study.

This study aimed to determine the benefits of sclerotherapy with OK-432 for the treatment of postoperative chronic lymphocele. Postoperative chronic lymphocele formation is common and accounts for a high postoperative morbidity. Nonsurgical strategies comprise repetitive percutaneous fluid aspiration or percutaneous sclerotherapy. OK-432 has been used to treat congenital lymphatic malformations with several reports of promising results. We hypothesized that it is more beneficial than repetitive percutaneous fluid aspiration for the treatment of symptomatic lymphocele. Two cohorts of melanoma patients who developed recurrent lymphocele after lymph node dissection from January 2013 to August 2017 were compared. The first cohort was treated with repetitive percutaneous fluid aspiration (n = 20). The second cohort received OK-432 sclerotherapy (n = 20). Primary end points were overall treatment duration, number of treatment sessions, and the clinical success in both cohorts. Secondary end points were surgical site infection rate, need for additional antibiotic treatment, wound healing disorders, and the need for revision surgery. Mean overall duration of treatment with sclerotherapy was significantly shorter than with repetitive aspiration (9.4 ± 7.2 vs 47.5 ± 31.9 days, P < 0.01). Mean number of sclerotherapy treatment sessions were 2.5 ± 1.2. Clinical success with OK-432 was 19 of 20, and that with repeated aspiration was 7 of 20 (χ = 15.82, P < 0.001). No surgical site infection occurred in the sclerotherapy cohort, which was significantly lower than those treated with repetitive aspiration (P < 0.03). Surgical revision was mandatory in 12 of 20 patients who were treated with repetitive aspiration, and only 1 of 20 patients in the sclerotherapy cohort. Sclerotherapy with OK-432 for the treatment of postoperative lymphocele is highly beneficial with a significant reduction of morbidity and the overall treatment time compared with repetitive aspiration.

Sclerotherapy treatment of an assumed aneurysmal bone cyst in a dog

A 3-month-old, 18 kg, female St Bernard breed dog was presented with recurrent left forelimb lameness and painful swelling of the antebrachium. A large expansile lytic lesion within the left...