Abstract No. 309 Risk of Adverse Events in Sclerotherapy for Vascular Malformations

This meta-analysis aimed to evaluate procedure related adverse events (AE) in patients with vascular malformations treated with imaged-guided sclerotherapy, which could facilitate treatment planning. Between 1990 to 2023, a total of 177 published studies describing treatment of vascular malformations were collected from PubMed. Fifty-five studies met inclusion criteria and were analyzed. Compiled AE rates were calculated for common and rare events, by patient and by session. Four studies reported AE count based on institutional cohorts (mean, 40.25 patients). Poisson regression with robust estimation was used to estimate the pooled AE rate and 95% confidence interval. Poisson regression was also used to assess the association between embolization agent and AE rate. The remaining studies reported AEs narratively, as individual case studies. We consider these rare AEs, assuming a large patient volume in each institute. The pooled analysis revealed the most frequently encountered AE by treatment session was unspecified necrosis (11.63% [2.13-63.50] 95%CI) followed by skin necrosis (3.58% [1.08-11.82] 95%CI) and joint stiffness (3.50% [0.64-19.07] 95%CI) based on treatment session (Table 309.1). Among the remaining rare AEs from 49 case studies, 4 were neurologic, 3 were dermal, and there were two or fewer in the remaining categories (systemic, cardiac, renal, hematologic, and musculoskeletal) for a total of 14 rare AEs. Based on reported literature from the last two decades, sclerotherapy is a safe and effective treatment modality for patients with vascular malformation as evident by the relatively low occurrences of AEs demonstrated in this meta-analysis.