Percutaneous Treatment of Peripheral Vascular Malformations in Children: Long-Term Clinical Outcome

• Published in: Cardiovascular and interventional radiology Vol. 35; no. 2; pp. 316 - 324
• Main Authors: van der Linden, Edwin, Otoide-Vree, Marleen, Pattynama, Peter M. T.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01-04-2012; Springer Nature B.V
• Subjects: Adolescent; ADULTS; AGE GROUPS; AGED ADULTS; ANIMALS; Cardiology; Child; Child, Preschool; CHILDREN; Clinical Investigation; Clinical outcomes; Cohort Studies; Edema - etiology; ELDERLY PEOPLE; Embolization, Therapeutic - adverse effects; Embolization, Therapeutic - methods; Female; Follow-Up Studies; HUMAN POPULATIONS; Humans; Imaging; Infant; Male; MALFORMATIONS; MAMMALS; MAN; Medicine; Medicine & Public Health; MINORITY GROUPS; Nuclear Medicine; Pain - etiology; PATHOLOGICAL CHANGES; Patient Satisfaction - statistics & numerical data; PATIENTS; POPULATIONS; PRIMATES; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Retrospective Studies; Sclerosing Solutions - therapeutic use; Sclerotherapy - adverse effects; Surveys and Questionnaires; SYMPTOMS; Treatment Outcome; Ultrasound; Vascular Malformations - therapy; VERTEBRATES; Vascular malformations; Embolotherapy; Embolization; Pediatric interventions; Sclerotherapy; Arteriovenous
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-011-0170-6

Purpose
This study was designed to assess the rate of complications and clinical failure at 3 and 12 months after percutaneous treatment of vascular malformations in children. Furthermore, we describe patient satisfaction of treatment results during 5 years of follow-up.
Methods
In a retrospective cohort study, we evaluated 26 patients younger than aged 19 years who were treated for symptomatic vascular malformations. Data on treatment outcomes and patient satisfactions were obtained with a precoded structured questionnaire. Patient files and imaging data were retrieved to obtain information regarding the vascular malformations and treatment. Clinical success was defined as disappearance or partial improvement of the complaints. Patient satisfaction was declared whenever patients answered in the questionnaire that they were satisfied with the treatment results.
Results
Of 26 eligible patients, we included 23 (88%). The mean follow-up was 36 (range, 15–127) months. Posttreatment, 87% (20/23; 95% confidence interval (CI), 66–97%) of patients reported clinical success at 3 months. At 1, 2, 3, 4, and 5 years of follow-up this percentage was 74%, 59%, 59%, 59%, and 59%, respectively. Eleven (48%, 95% CI 27–69%) patients had experienced complications and 22% (95% CI 7–44%) had major complications, of which 5 had required additional treatment. In all, 83% (19/23) of the patients reported satisfaction with the treatment.
Conclusions
Percutaneous treatment of vascular malformations improved clinical symptoms in 87% of the patients at 3 months and were sustainable for half of all patients during a 5-year follow-up period. However, major complications were seen in 22%.