TY - JOUR
T1 - Effectiveness of sclerotherapy, surgery, and laser therapy in patients with venous malformations
T2 - a systematic review
AU - van der Vleuten, Carine J M
AU - Kater, Anne
AU - Wijnen, Marc H W A
AU - Schultze Kool, Leo J
AU - Rovers, Maroeska M
PY - 2013/11
Y1 - 2013/11
N2 - PURPOSE: Because the best possible treatment for venous malformations is unclear, this study systematically reviews the available literature regarding the effectiveness of different treatment options for the patient group. Venous malformations result from incorrect development of the veins during embryogenesis and are present at birth. Venous malformations may exhibit symptoms, such as pain, swelling, and inflammation of the vessel.MATERIALS AND METHODS: A systematic literature search in PubMed and Embase was performed. Data regarding the design, participants, intervention and, treatment outcome (success and complications) were extracted. The validity of the studies was assessed with the Cochrane Collaboration's risk of bias tool.RESULTS: Thirty-five studies were identified studying the effectiveness of eight treatments: sclerotherapy/embolization with ethanol, gelified ethanol, bleomycin, polidocanol, sodium tetradecyl sulfate (STS), Ethibloc, surgery, and laser therapy. All of the included studies have a high or unclear risk of bias. The average biased reported success rates for ethanol, gelified ethanol, bleomycin, polidocanol, STS, Ethibloc, surgery, and laser therapy were 74, 89, 88, 90, 86, 65, 90, and 94 %, respectively.CONCLUSION: Until more valid evidence is available, the choice for treatment remains a shared decision between the patient and a multidisciplinary treatment group. From a cost perspective, sclerotherapy with STS or polidocanol should be the treatment of choice.
AB - PURPOSE: Because the best possible treatment for venous malformations is unclear, this study systematically reviews the available literature regarding the effectiveness of different treatment options for the patient group. Venous malformations result from incorrect development of the veins during embryogenesis and are present at birth. Venous malformations may exhibit symptoms, such as pain, swelling, and inflammation of the vessel.MATERIALS AND METHODS: A systematic literature search in PubMed and Embase was performed. Data regarding the design, participants, intervention and, treatment outcome (success and complications) were extracted. The validity of the studies was assessed with the Cochrane Collaboration's risk of bias tool.RESULTS: Thirty-five studies were identified studying the effectiveness of eight treatments: sclerotherapy/embolization with ethanol, gelified ethanol, bleomycin, polidocanol, sodium tetradecyl sulfate (STS), Ethibloc, surgery, and laser therapy. All of the included studies have a high or unclear risk of bias. The average biased reported success rates for ethanol, gelified ethanol, bleomycin, polidocanol, STS, Ethibloc, surgery, and laser therapy were 74, 89, 88, 90, 86, 65, 90, and 94 %, respectively.CONCLUSION: Until more valid evidence is available, the choice for treatment remains a shared decision between the patient and a multidisciplinary treatment group. From a cost perspective, sclerotherapy with STS or polidocanol should be the treatment of choice.
KW - Humans
KW - Laser Therapy
KW - Risk Factors
KW - Sclerosing Solutions
KW - Sclerotherapy
KW - Vascular Malformations/therapy
KW - Vascular Surgical Procedures
U2 - 10.1007/s00270-013-0764-2
DO - 10.1007/s00270-013-0764-2
M3 - Review article
C2 - 24196269
SN - 0174-1551
VL - 37
SP - 977
EP - 989
JO - Cardiovascular and interventional radiology
JF - Cardiovascular and interventional radiology
IS - 4
ER -