[Usefulness of percutaneous sclerosing treatment for low-flow vascular lesions].

Peripheral vascular lesions may occur as a result of various clinical problems, cosmetic or dysfunctional causes, or bleeding. In severe cases, coagulopathy and congestive heart failure may occur. Although the efficacy of transarterial embolization (TAE) for arterial vascular lesions is well known, TAE has no effect on low-flow vascular lesions (venous malformations, venous angiomas, and venous components of arteriovenous malformation). Therefore, in such cases, a percutaneous approach is the best method, and we consider sclerotherapy to be the most useful conservative treatment. The primary objective of this study was to confirm the efficacy of percutaneous sclerosing treatment for peripheral low-flow vascular lesions. Lesions were classified on the basis of state of blood flow and morphologic features, and infiltration was classified on the basis of angiographic features and magnetic resonance imaging (MRI) findings. In sclerosing treatment, we used 5% solutions of polidocanol, absolute ethanol, and N-butyl-2-cyanoacrylate (NBCA) as sclerosing agents. Each type of lesion, static or slow-flow, cystic, or localized, showed remarkable improvement after sclerosing treatment with only polidocanol. However, for moderate-to-fast-flow lesions, another sclerosing agent (absolute ethanol/NBCA) was needed. With diffuse infiltrative lesions, surgical repair might be needed, but we recognize the usefulness of sclerosing treatment for functional or cosmetic improvement in these cases.