1.Endovascular treatment for venous malformations with three-point anhydrous ethanol injection.
Qizhen WU ; Jiaguang LI ; Shaorong LEI ; Wuyuan TAN ; Jianhong LONG
Journal of Central South University(Medical Sciences) 2015;40(8):907-911
OBJECTIVE:
To explore the safe method with anhydrous ethanol injection in the treatment of venous malformation.
METHODS:
A total of 96 patients with venous malformation were conducted anhydrous ethanol injection for 245 times through percutaneous puncture by three-point method. The complications were observed. In animal experiment, according to the different concentrations of anhydrous ethanol injection, rats were divided into an anhydrous ethanol group, a 75% ethanol group, a 50% ethanol group and a 25% ethanol group (n=5 in each group), and the damage of vessels after ethanol injection was observed.
RESULTS:
The successful rate for three-point ethanol injection was 88%. The incidence for both skin ulcer and numbness was 0.9% without severe complications in lung and heart. In the animal experiments, the entire vessel wall including outer membrane was damaged in the anhydrous ethanol group. Part of vessel walls, including the inner membrane and muscle layer, were damaged in both the 75% ethanol group and the 50% ethanol group. However, there was no damage in the vessels in the 25% ethanol group.
CONCLUSION
With the decrease in ethanol concentration, the vascular damage is decreased and eventually disappeared. Three-point anhydrous ethanol injection is safe and effective.
Animals
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Ethanol
;
administration & dosage
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therapeutic use
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Humans
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Injections
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methods
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Rats
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Sclerosing Solutions
;
therapeutic use
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Sclerotherapy
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Vascular Malformations
;
therapy
2.Sonographically guided intralesional sclerotherapy for venous malformation.
Li ZHANG ; Jun WANG ; Cheng-shu ZHANG ; Ping-hui ZHOU ; Jing-yu QIAN ; Xu-wen LI ; Shu-xing GE
Chinese Journal of Surgery 2008;46(19):1472-1474
OBJECTIVETo investigate the safety and efficacy of sonographically guided percutaneous intralesional sclerotherapy for peripheral venous malformations.
METHODSFrom March 2004 to October 2007, 32 patients with venous malformations of soft tissues were treated with sonographically guided intralesional sclerotherapy. The malformed venous space was identified intraoperatively by duplex scanning, the gauge 7 needle was inserted into this venous space under real-time ultrasound visualization, and sclerosants were infused in the space gently. Absolute alcohol and bleomycin acted as sclerosants here, combined the two (for type I malformation) or bleomycin only (for type II malformation). The treatment could be repeated if the lesion was not cured in 3 weeks. All patients were followed up for 6 months to 2 years.
RESULTSOf the group, each patient received 1 - 6 times of the therapy (mean, 3 times). Twenty-seven patients achieved a complete response, and 5 achieved partial response. No major complications occurred.
CONCLUSIONSSonographically guided percutaneous intralesional sclerotherapy for peripheral venous malformation is a simple, effective, safe therapy with minimal invasion, lower morbidity rate, and can be repeated.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Sclerosing Solutions ; administration & dosage ; Sclerotherapy ; Ultrasonography ; Vascular Malformations ; diagnostic imaging ; therapy ; Veins ; abnormalities ; diagnostic imaging
3.Cyst Ablation Using a Mixture of N-Butyl Cyanoacrylate and Iodized Oil in Patients with Autosomal Dominant Polycystic Kidney Disease: the Long-Term Results.
See Hyung KIM ; Seung Hyup KIM ; Jeong Yeon CHO
Korean Journal of Radiology 2009;10(4):377-383
OBJECTIVE: We wanted to assess the long-term results of cyst ablation with using N-butyl cyanoacrylate (NBCA) and iodized oil in patients with autosomal dominant polycystic kidney disease (ADPKD) and symptomatic cysts. MATERIALS AND METHODS:Cyst ablation using a mixture of NBCA and iodized oil was performed in 99 cysts from 21 patients who had such symptoms as abdominal distension and pain. The collapse or reaccumulation of the ablated cysts after the procedure was assessed during the follow-up period of 36 to 90 months. The treatment effects, including symptom relief, and the clinical data such as the blood pressure and serum creatinine levels were also assessed, together with the complications. RESULTS: The procedure was technically successful in all 99 cysts from the 21 patients. Any procedure-related significant complications were not detected. Seventy-seven of 99 cysts (78%) were successfully collapsed on the follow-up CT. Twenty-two cysts showed reaccumulation during long-term follow-up period. The clinical symptoms were relieved in 17 of the 21 patients (76%). Four of 12 patients (33%) with hypertension and two of six patients (33%) with azotemia were improved. End stage renal disease (ESRD) occurred in six of the 21 patients (28%) during the follow-up period. The mean age of ESRD in our patients was 57 years. The mean time interval for the development of ESRD was 19 months. CONCLUSION: Ablation using a mixture of NBCA and iodized oil may be an effective, safe method for obtaining symptom relief in patients with ADPKD.
Adult
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Aged
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Enbucrilate/administration & dosage/*therapeutic use
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Female
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Follow-Up Studies
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Humans
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Iodized Oil/administration & dosage/*therapeutic use
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Male
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Middle Aged
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Polycystic Kidney, Autosomal Dominant/*surgery
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Sclerosing Solutions/administration & dosage/*therapeutic use
4.Application of 1% lauromacrogol in the treatment of facial refractory hemangioma and vascular malformations.
Yin WANG ; Fei ZHU ; Jin-long NING ; Xiao-jing LI ; Ye LIU
Chinese Journal of Plastic Surgery 2012;28(6):428-431
OBJECTIVETo investigate the clinical effect of 1% lauromacrogol for the treatment of facial refractory hemangioma and vascular malformation.
METHODSFrom Sept 2009 to Nov 2011, 55 patients (20 male, 35 female, 1 month to 30 years) with different types of facial hemangiorwa and vascular malformation about 1.0 cm x (0. 5-5.0) cm x 10.0 cm in size, underwent 1% lauromacrogol intratumor injection therapy. Generally, the injection dose, concentration, frequency were determined by the age of the patients, the volume and depth of the lesion. The dose was limited to 10 mg every time. The injection interval is 14 weeks.
RESULTSAfter followed up for 3-16 months, 41 cases were cured, 9 cases were greatly improved, and 5 were partially improved. Skin necrosis happened in only 2 cases.
CONCLUSIONSLauromacrogol is safe, simple and effective as a sderosing agent for the treatment of facial refractory hemangioma and vascular malformation. It provides a new and alternative way for the treatment of facial refractory hemangioma and vascular malformation.
Adolescent ; Adult ; Child ; Child, Preschool ; Face ; blood supply ; Facial Neoplasms ; drug therapy ; Female ; Hemangioma ; drug therapy ; Humans ; Infant ; Injections, Intralesional ; Male ; Polyethylene Glycols ; administration & dosage ; Sclerosing Solutions ; administration & dosage ; Vascular Malformations ; drug therapy ; Young Adult
5.Ultrasound guided percutaneous puncture and sclerotherapy with alcohol for peripelvic cysts.
Shu-qing LI ; Xue-song LI ; Yong-liang DONG ; Zhi-song HE ; Tong-li XIA ; Yan-qun NA
Chinese Journal of Surgery 2005;43(22):1461-1463
OBJECTIVETo summarize the experience of ultrasound guided percutaneous aspiration and sclerotherapy for peripelvic cysts and investigate the clinical effect.
METHODSA total of 169 cases of peripelvic cyst patients were evaluated, of whom 36 cases (21.3%) had hydronephrosis secondary to peripelvic cysts, 8 cases (4.7%) had renal calculus. All patients underwent ultrasound and intravenous phelography (IVP) examination, 59 patients also had CT scan. Hydatid fluid was analyzed by amine test. Percutaneous aspiration was guided by ultrasound, 95% alcohol was used to sclerosis the peripelvic cysts when amine test was negative or positive but did not have communication with pelvis through opacification. Ultrasound were done at 1, 3, 6 months and every 1 year thereafter, follow-up period were 6 months to 5 years.
RESULTSOne hundred and sixty-five peripelvic cysts (97.6%) were cured by once sclerotherapy, the diameter of another 4 cases (2.4%) diminished to less than 1.5 cm by once sclerotherapy. Thirty-six cases of hydronephrosis were all resolved after sclerotherapy. Eight cases had renal calculus, of whom 4 cases underwent extracorporeal shockwave lithotripsy, 2 cases underwent percutaneous nephrolithotomy, and 2 cases did not treat the stone. Five patients had gross hematuria after aspiration, but all diminished in 3-5 d.
CONCLUSIONUltrasound guided percutaneous aspiration and sclerotherapy for peripelvic cysts had the superiority of safety, effectiveness micro-invasion and low complication.
Adolescent ; Adult ; Aged ; Child ; Combined Modality Therapy ; Ethanol ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Injections, Intralesional ; Kidney Diseases, Cystic ; diagnostic imaging ; therapy ; Kidney Pelvis ; Male ; Middle Aged ; Paracentesis ; methods ; Sclerosing Solutions ; administration & dosage ; Sclerotherapy ; methods ; Ultrasonography
6.Long-term outcome after injection sclerotherapy for esophageal variceal bleeding in children with portal hypertension.
Chun-Di XU ; Chao-Hui DENG ; Yin ZHANG ; Lin SU ; Shun-Nian CHEN
Chinese Journal of Pediatrics 2004;42(8):574-576
OBJECTIVEEndoscopic sclerotherapy has emerged as an effective treatment for bleeding esophageal varices in adults and children but the long-term outcome is poorly defined in children. The present study aimed to study the long-term effect of endoscopic sclerotherapy in children with portal hypertension.
METHODSFifteen patients (age 3 to 14 years) with esophageal variceal bleeding underwent endoscopic injection treatments with 1% Aethoxy-sclerol since 1996. All subjects continued to receive the therapy by repeated intra and extravariceal endoscopic sclerotherapy at intervals of 3 - 4 weeks until the varices disappeared, and received regular endoscopic follow-up.
RESULTSFifteen patients had totally 43 injections, and were followed up from 40 to 86 months (mean 66 months) by endoscopy. Two patients received 2 injections and 5 received 3 before eradication of varices. The mean time needed for varices eradication was 3 to 6 months. Recurrence of varices and bleeding was seen in 3 patients who had duodenal ulcer.
CONCLUSIONEndoscopic sclerotherapy is a safe and effective treatment for pediatric esophageal varices.
Adolescent ; Child ; Child, Preschool ; Duodenal Ulcer ; complications ; Esophageal and Gastric Varices ; etiology ; therapy ; Esophagoscopy ; Gastrointestinal Hemorrhage ; etiology ; therapy ; Humans ; Hypertension, Portal ; complications ; Injections, Intralesional ; Polyethylene Glycols ; administration & dosage ; Recurrence ; Reoperation ; Sclerosing Solutions ; administration & dosage ; Sclerotherapy ; Time Factors ; Treatment Outcome
7.Treatment of renal cysts with imaging-guided percutaneous catheterization drainage and alcohol sclerosis.
Wei-lang HUANG ; You-zhi WANG ; Xin LIN ; Biao LIU
Journal of Southern Medical University 2010;30(7):1670-1672
OBJECTIVETo investigate the effect and safety of imaging-guided percutaneous catheterization drainage and alcohol sclerosis for treatment of renal cysts.
METHODSThirty-six patients with primary renal cysts, including 22 men and 14 women aged 18-65 years (mean 42.5 years), were treated with imaging-guided percutaneous puncture catheterization drainage and alcohol sclerosis treatment. The location of the renal cysts and puncture route, angle and depth were determined by ultrasound or CT scan. Paracentesis and catheterization external drainage were carried out under fluoroscope. Absolute alcohol was used as the sclerosis agent.
RESULTSThirty-eight cysts were detected in the 36 patients, locating at the upper pole (n=21), subtus pole (n=10) and intermediate pole (n=7). The length of renal cysts was 4.5-8.5 cm (mean 5.5 cm). Puncture was performed through the lumbar back and the success rate was 100%. Thirty-eight multi-lateral holes 5-7F drainage catheters were placed in the 38 cysts. Alcohol was injected for 169 times through the drainage tube and the average volume was 25 ml, with an average injection of 4.45 times. During the follow-up for 1 to 6 years (mean 3.5 years), 37 renal cysts disappeared and 1 cyst was reduced in a patient with polycystic kidney. The total cure rate was 97% in this series, and no serious complications occurred after the operation.
CONCLUSIONImaging-guided percutaneous puncture catheterization drainage and alcohol sclerosis is effective and safe for treatment of renal cysts.
Adolescent ; Adult ; Aged ; Catheterization ; Drainage ; methods ; Ethanol ; administration & dosage ; Female ; Humans ; Kidney Diseases, Cystic ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Sclerosing Solutions ; administration & dosage ; therapeutic use ; Sclerotherapy ; methods ; Ultrasonography ; Young Adult
8.Comparison of the clinical therapeutic effects between local injection of pingyangmycin and sodium morrhuate on oral and maxillofacial venous malformation.
Wei HE ; Ai-Ling GU ; Jun-Lan SHANG
Chinese Journal of Stomatology 2007;42(5):308-309
OBJECTIVETo observe and compare the curative effect of pingyangmycin and sodium morrhuae respectively in the treatment of oral and maxillofacial venous malformation.
METHODSForty cases of oral and maxillofacial venous malformation were induced in this study, 20 of which were given local injection of low dose of pingyangmycin, and 20 given local injection of 5% sodium morrheate. The therapeutic effects were observed.
RESULTSThe effective cases of pingyangmycin was 19, and the effective cases of sodium morrhuate was 12. The side effect was found in 10 cases of, and in 15 cases sodium morrhuate group, the former was mainly pingymangmycin group systemic, the later was mainly local. The difference was significant between the two groups (P < 0.05).
CONCLUSIONSPingyangmycin is more effective in effective rate and side effect treatment of venous hemangioma than sodium morrhuate.
Adolescent ; Adult ; Bleomycin ; administration & dosage ; analogs & derivatives ; therapeutic use ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Injections, Intralesional ; Male ; Middle Aged ; Sclerosing Solutions ; therapeutic use ; Sodium Morrhuate ; administration & dosage ; therapeutic use ; Treatment Outcome ; Vascular Malformations ; therapy ; Young Adult
9.Evaluation of absolute alcohol treatment for renal cyst with percutaneous puncture and catheterization under ultrasonographic guidance.
Wei-bing SUN ; Bo YANG ; Hui LIU ; Zhi-lu FAN ; Yong-ji LIU ; Wen-tong LIU
Chinese Journal of Surgery 2004;42(10):590-592
OBJECTIVETo evaluate the effect of absolute alcohol treatment for renal cyst with percutaneous puncture and catheterization.
METHODSThis report presented 64 cases of renal cysts, 34 cases were treated with percutaneous puncture (A group) and 30 cases with percutaneous catheterization (B group). According to the size, the cysts were divided into 2 groups, more than 6 cm in diameter and less than 6 cm in diameter.
RESULTSAll the patients were followed up for 3 - 12 months by CT or B ultrasonography. Striking difference of the therapeutic results were existed when cystS were more than 6 cm in diameter.
CONCLUSIONPercutaneous catheterization is applicable to the sclerosing treatment of renal cyst whose diameter is more than 6 cm.
Adult ; Aged ; Catheters, Indwelling ; Combined Modality Therapy ; Ethanol ; administration & dosage ; Female ; Humans ; Injections, Intralesional ; Kidney Diseases, Cystic ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Paracentesis ; methods ; Sclerosing Solutions ; administration & dosage ; Treatment Outcome ; Ultrasonography, Interventional
10.Fluoroscopy-Guided Endovenous Sclerotherapy Using a Microcatheter Prior to Endovenous Laser Ablation: Comparison between Liquid and Foam Sclerotherapy for Varicose Tributaries.
Sang Woo PARK ; Ik Jin YUN ; Jae Joon HWANG ; Song Am LEE ; Jun Seok KIM ; Hyun Keun CHEE ; Il Soo CHANG
Korean Journal of Radiology 2014;15(4):481-487
OBJECTIVE: To compare the efficacy and adverse effects of endovenous foam sclerotherapy (EFS) and liquid sclerotherapy (ELS) using a microcatheter for the treatment of varicose tributaries. MATERIALS AND METHODS: From December 2007 to January 2009, patients with venous reflux in the saphenous vein were enrolled. The foam or liquid sclerosant was injected through a microcatheter just before endovenous laser ablation (EVLA). Patients were evaluated for the technical success, clinical success, and procedure-related complications during the procedure and follow-up visits. RESULTS: A total of 94 limbs were included: 48 limbs (great saphenous vein [GSV], 35; small saphenous vein [SSV], 13) were managed using EFS and EVLA (foam group; FG), and 46 limbs (GSV, 37; SSV, 9) were treated by ELS and EVLA (liquid group; LG). Varicose tributaries demonstrated complete sclerosis in 92.7% with FG and in 71.8% with LG (p = 0.014). Bruising (78.7% in FG vs. 73.2% in LG, p > 0.05), pain or tenderness (75.6% in FG vs. 51.2% in LG, p = 0.0237) were noted. Hyperpigmentation (51.2% in FG vs. 46.2% in LG, p > 0.05) was found. CONCLUSION: Endovenous foam sclerotherapy using a microcatheter is more effective than ELS for eliminating remnant varicose tributaries prior to EVLA. However, EFS is more commonly associated with local complications such as pain or tenderness than ELS. Furthermore, both techniques seem to prolong the duration of hyperpigmentation along with higher costs.
Catheters/adverse effects
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Femoral Vein
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Fluoroscopy/methods
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Humans
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Laser Therapy/methods
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Radiography, Interventional/methods
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*Saphenous Vein/radiography/surgery
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Sclerosing Solutions/*administration & dosage/chemistry
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Sclerotherapy/adverse effects/instrumentation/*methods
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Treatment Outcome
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Varicose Veins/radiography/*therapy
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Venous Insufficiency/surgery