Sclerotherapy

Sclerotherapy is used to treat certain types of vascular and lymphatic malformations. The physician injects a liquid medication into the malformation. The liquid causes inflammation, and then, over time, shrinks the malformation.

Sometimes malformations become enlarged again, and repeat sclerotherapy will be needed. (About 25% of patients require more than one treatment, which are spaced three months apart.)

The Procedure

Using ultrasound for guidance, the physician will insert a small needle into the malformation. Next, X-ray dye (contrast) and the liquid medication (sclerosant) will be injected into the malformation. Depending on the size of the malformation, several injections of sclerosant may be needed. For larger lesions, small drainage catheters may be placed.

Anesthesia

Children are not awake for sclerotherapy. Depending on your child’s medical history and the location of the malformation, we will use either IV sedation or general anesthesia.

This procedure takes about one hour.

Risks

Sclerotherapy is considered a low-risk procedure. Although it has been proven to be safe and effective, side effects occasionally occur. These may include:

• skin blistering, scarring or ulceration
• infection
• numbness due to nerve damage
• injury to surrounding structures (skin, nerves or organs)
• localized tissue loss
• allergic reaction to X-ray dye or sclerosant
• blood in the urine

Pain

Your child may experience some discomfort from swelling and bruising after the procedure. This should improve gradually during the first week, but will not go away completely until the blood clots are absorbed, which could take up to two months.

Over-the-counter pain medication should provide relief. Ask your doctor about stronger pain medicine if necessary.

Bathing after the Procedure

Your child may shower or take a bath after 24 hours when the bandage is removed. However, if drainage catheters were needed, they will remain in place for about a week. During that time, the site must remain dry and your child may only take sponge baths.

Activity Restrictions

Your doctor will discuss restrictions with you based on your child’s situation. Generally, your child may resume normal activity as soon as he/she feels comfortable doing so. However, heavy lifting and contact sports should be avoided for two weeks.

If the area treated was on the leg, hip or foot, crutches may be needed for 3-4 days. If compression stockings were worn prior to treatment, your child may resume wearing them in 24 hours.

Other Considerations

Be sure to call the Interventional Radiology Department (650-736-4747) if you have questions or concerns or if your child has any of these symptoms:

• bleeding from the treated area
• severe or progressive swelling or redness
• fever over 101^o
• pain that does not go away with medication
• blackened areas of skin or blisters