Abstract Background: Clinical success of sclerotherapy in the management of low flow vascular malformations (LFVM) patients depends on many factors. Objective: To document the correlates of sclerotherapy in the management of LFVM patients. Methodology: This retrospective and record-based study was done on LFVM patients who underwent sclerotherapy and their demographic data, clinical symptoms, site, therapy used (agents/cycles), and imaging details were extracted from the patient records. The categorical data were summarized as n (%). Associations with net clinical benefit were evaluated using Chi-square/Fisher’s exact tests, with crude odds ratios and P values. Results: Among 65 patients, 61 (93.8%) achieved good clinical outcome in form of symptomatic relief after sclerotherapy. LFVM affected lower limb, head and neck (79%) of younger subjects mainly. Swelling was the most common presentation. Lesion size reduction was associated with higher symptomatic improvement rates (96.1% vs. 85.7%). Clinical improvement was observed in 85.7% of patients treated with sodium tetradecyl sulfate (STS) and in 100% of those who received bleomycin or combination therapy ( P = 0.06). Furthermore, complications differed significantly by sclerosant type ( P = 0.044), occurring most frequently with STS (46.4%) and less often with bleomycin (23.1%) and combination therapy (16.7%), indicating a safer profile for the latter agents. The number of treatment cycles did not significantly affect clinical improvement ( P = 0.162) or complication rates ( P = 0.677). Conclusion: Bleomycin based or combination sclerotherapy regimens yield better clinical improvement and fewer complications than STS, with lesion size reduction and imaging response serving as key indicators of treatment success.
Singh et al. (Wed,) studied this question.