Sclerotherapy of Vascular Malformations

Sclerotherapy involves the obliteration of various malformations (also called angiodysplasias) in the head, neck and facial region by means of a direct image-guided puncture through the skin. Angiodysplasias are usually congenital and consist of malformed veins (venous angioma), lymphatic vessels (lymphangioma), capillaries (capillary malformation), or a combination of these. Angiodysplasias can cause local pain, functional limitations, especially in the eye, mouth and throat region, or aesthetic impairment. Sclerotherapy is performed by puncturing the lesion with a needle using imaging guidance (either ultrasound or fluoroscopy) and by injecting a special drug into the lesion. The drug provokes an inflammatory reaction with subsequent adhesion of the wall structures of the cavities, thereby reducing the size of the angiodysplasia. Sclerotherapy can usually be performed on an outpatient basis under local anesthesia of the skin.

In rare cases, general anesthesia is necessary for more complex and extensive angiodysplasias. The aim of the therapy is to reduce the size of the angiodysplasia as much as possible. Depending on the size and extent of the lesion, several therapy sessions at intervals of several weeks may be necessary. Immediately after sclerotherapy, swelling and local pain as an expression of the inflammatory reaction are common findings. These symptoms usually subside within a few days and usually respond well to superficial cooling and painkillers.