Khawla Boughanmi MD, Presenter: Nothing to Disclose

Khalil Riadh Hamza MD, Abstract Co-Author: Nothing to Disclose

Intra lesion injection of sclerosant agent and peripheral compression of venous out flow are responsible of elevation of intra lesion’s pressure that can induce peripheral diffusion of the sclerosis agent. We developed the concept of (LPS)  by placing multiple needles in the (PVM).These needles work as multiple valves that allow the free circulation of the sclerosant agent and the outflow of the extra injected fluid.This technique is used for the treatment of low flow vascular malformations and peripheral AVM (nidus and venous side)

In a period of76months (September 2006-december 2013),170 patients were treated with this concept:122 patients with venous malformations (VM), 28 patients with lymphatic malformation(LM) including 26 patients with macro cystic LM and two patients with micro cystic LM and 20 patients with superficial (AVM).3% tetradecyl sulphate foam, and since three years, lauromacrogol 400 have been used in all cases of VM(20-60 ml)and in two case of micro cystic LM. Absolute ethanol (AE) was used in 88 patients:in 44VM complementary to foam, in 24 LM and in 20 cases of peripheral AVM. Glue (isobutyl 2 cyanoacrylate) was used in4 cases of AVM complementary to AE or before using AE.Up to7 sessions were performed per patient  

Technical success was reached in all cases. Loss of volume at MRI ranged from 25% to 80% except for two patients who presented with large size VM.All patients were cosmetically improved and relieved of pain. Swelling of the lesion occurred in all treated cases and it was well tolerated and controlled with NSAIDs with resolution in few days(4-7days). Significant complications occurred in 3 patients and consisted of phlyctena, fistula and necrosis.They were managed conservatively

LPS concept using 3% STS foam,lauromacrogol and AE in our experience over more than six years has proven the technique to be effective with dramatic decreasing of complications.AE is used to treat macro cystic LM, superficial AVM and complementary to STS foam in some VM with extreme care concerning the volume injected

Placing multiple needles in peripheral Vascular malformation allow free circulation of the sclerosing agent these needles work as multiple valves that allow an exit of the sclerosing agent .The technique is effective with dramatic decreasing of complication.Actually we used this approach to treat  VM, cystic LM and superficial AVM

Boughanmi, K, Hamza, K, Treatment of Peripheral Vascular Malformation (PVM): A New Concept of Low Pressure Sclerotherapy (LPS).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019490.html