Duplex-guided foam sclerotherapy for the treatment of the symptomatic venous malformations of the face

BACKGROUND. New sclerosing foam is considered to have the advantage of causing more damage on the intima than liquid form. Therefore we recently applied duplex-guided foam sclerotherapy in a patient with venous malformations of the face. METHODS. A 20-year-old man was referred to our institute for the evaluation and treatment of vascular malformations of the face. Preoperative duplex scanning and magnetic resonance imaging (MRI) revealed subcutaneous and intramuscular venous malformations. The sclerosing foam was produced by Tessari's method using 1% polidocanol, and the duplex-guided foam sclerotherapy was performed under general anesthesia. A 20-gauge plastic needle was inserted into the venous space using ultrasound guidance and a total of 5 ml of sclerosing foam was infused followed by immediate tie-over dressing. RESULTS. The venous malformations were successfully reduced in size and postoperative MRI showed significant reduction of the venous malformations. CONCLUSION. Although further collective study is necessary to ensure the validity of this treatment, duplex-guided foam sclerotherapy could have great promise in the treatment of symptomatic venous malformations.