Sclerotherapy is a nonsurgical way to treat certain types of vascular malformations, which are abnormal clusters of blood vessels that occur during fetal development.
Sclerotherapy is used to reduce the size of venous and lymphatic malformations or to eliminate pain that is associated with them. Depending on the depth, location and extent of these malformations, sclerotherapy is sometimes used with other therapies, including surgical removal of the malformation.
When your child’s procedure is scheduled, you will be given specific information from the interventional nurse for arrival time and eating instructions. Your child may be seen in the HVMC clinic and/or the interventional clinic prior to scheduling the procedure. The radiologist will discuss the treatment plan with you at the clinic visit and you will meet the nurse practitioner, nurse and interventional radiology technologist that will assist during your child’s procedure.
Your child will receive general anesthesia and will not experience pain during the procedure. You will be able to stay with your child until anesthesia is administered for the procedure. You will be escorted to the surgical waiting area where the doctor will talk to you after the procedure.
Using X-ray and ultrasound equipment, a doctor called an interventional radiologist, places a small needle into the vascular malformation and injects it with a chemical substance called a sclerosant. The sclerosant causes clotting, inflammation and eventual shrinkage of the malformation. There are several different agents the doctor may use; it depends on the type of malformation being treated and the intended result.
Depending on the size and shape of the malformation, more than one injection may be needed. The procedure usually takes two to three hours; however, its beneficial effects may not be seen for up to two months.
As your child begins to wake up from the anesthesia, he/she will be taken to the Post Anesthesia Care Unit (PACU), where he/she will be closely observed. You will be brought to the PACU once your child is settled in and assessed. The injection areas are usually quite swollen and bruised. This is normal and is not cause for concern. If your child has severe swelling, he/she may be given a steroid medication, such as prednisone, to help reduce this. The radiologist will speak to you about the results after the procedure. When your child is ready, he/she will be moved from the PACU to a patient room, where he/she will remain overnight for careful observation or may be discharged from the PACU.
After the procedure, your child may experience some discomfort related to swelling and bruising. Swelling and bruising gradually decrease over the first week, but do not go away completely until the blood clots are absorbed, which may take up to two months. Skin inflammation is sometimes caused if the sclerosant leaks onto adjacent skin. If this occurs your physician or nurse practitioner will prescribe medication to reduce the discomfort. It is important that you do not give aspirin or medications that contain aspirin – unless prescribed by a member of the interventional radiology team. Aspirin may make your child more susceptible to bleeding.
After sclerotherapy your child will not have any restrictions on bathing or other routine activities; however, heavy lifting and contact sports should be avoided for two weeks. Your child may also have an ACE wrap to the site of the sclerosing. Children who have sclerotherapy to a leg or hip may need to use crutches for 3-4 days.
About 25 percent of patients require more than one treatment. These treatments generally are spaced at three-month intervals.
Although sclerotherapy has been proven to be safe and effective, side effects occasionally occur. These may include blistering, scarring, infection, numbness due to nerve damage and localized tissue loss.