• Cavernous angioma
• Cavernous hemangioma
• Head and neck
• Helium plasma
• Venous malformations

• Humans
• Male
• Female
• Electrosurgery/instrumentation
• Electrosurgery/methods
• Vascular Malformations/surgery
• Vascular Malformations/therapy
• Adult
• Helium
• Sclerotherapy/methods
• Plasma Gases/therapeutic use
• Middle Aged
• Neck/blood supply
• Young Adult
• Adolescent
• Head/blood supply
• Child
• Treatment Outcome

• Efficiency
• Glue embolization
• Procedure time
• Room time
• Venous malformation

• Hemangioma
• MRI
• Vascular tumors
• Venous malformation

• Bleomycin
• activated partial thromboplastin time
• complication
• pain
• polidocanol
• predictor
• thrombocytocrit
• venous malformation

• Humans
• Bleomycin/therapeutic use
• Sclerotherapy
• Polidocanol
• Retrospective Studies
• Pain/etiology
• Polyethylene Glycols

• Major New Drug Creation Special Project
• National Natural Science Foundation of China
• the International S&T cooperation program
• National High Level Hospital Clinical Research Funding

• Fat-suppressed T2-weighted imaging
• Magnetic resonance imaging
• Polidocanol sclerotherapy
• Short-term pain relief
• Venous malformations

• Humans
• Sclerotherapy/methods
• Polidocanol/therapeutic use
• Sclerosing Solutions/therapeutic use
• Retrospective Studies
• Vascular Malformations/complications
• Vascular Malformations/diagnostic imaging
• Vascular Malformations/therapy
• Pain/etiology
• Magnetic Resonance Imaging
• Extremities/diagnostic imaging
• Treatment Outcome

• foam sclerotherapy
• patient satisfaction
• patient-reported outcomes
• ultrasound-guided sclerotherapy
• venous malformation

• VM
• face
• outcome
• sclerotherapy
• slow-flow

In this manuscript, we purposed to identify the prognostic factors for treatment of lymphatic malformations in children using polidocanol foam combined with pingyangmycin and to construct nomogram for predicting sclerotherapy response.

A retrospective analysis of 77 children having LMs who underwent sclerotherapy using polidocanol foam combined with pingyangmycin under ultrasound display from January 2017 to April 2020 was done. The clinical response was graded as excellent (≥ 90%), good (≥ 50%, < 90%), and poor (< 50%). More than 50% was considered as acceptable response. Prognostic factors were identified by Pearson’s Chi-square or Fisher’s exact test and multivariable logistic regression model was used to construct a nomogram to predict sclerotherapy response. The discrimination and calibration of nomogram were verified through the receiver operating characteristic cure and calibration plots.

The mean number of treatment sessions was 3.1 (range, 1–6). Among 77 patients, 58 patients (75.3%) had excellent response to treatment (≥ 90%) and 68 patients (88.3%) had an acceptable response (≥ 50%, < 90%). Clinical disfigurement (P = 0.014), skin discoloration (P = 0.040), morphological subtype (P < 0.001) and extent of the lesion (P < 0.001) correlated with clinical response to sclerotherapy in LMs. Sclerotherapy response was predicted through nomogram constructed in this study, which shows good calibration and discrimination. Also, focal lesion and macrocystic or mixed morphological subtype lesion were seen more often in lower number of treatment sessions among the patients with excellent response.

An acceptable response to sclerotherapy using polidocanol foam combined with pingyangmycin was achieved in majority of LMs in children with extremely low complication rates. Nomogram based on the prognostic factors of sclerotherapy response for LMs in children was shown to possess an excellent performance to predict the probability of LMs sclerotherapy response.

• Lymphatic malformation
• Nomogram
• Pingyangmycin
• Polidocanol
• Sclerotherapy

Venous malformations (VMs) are the most common type of vascular malformations. Intramuscular venous malformations (IMVMs) are lesions involving the muscles, excluding intramuscular hemangiomas. The purpose of this study was to compare clinical outcomes between patients with IMVMs who were treated with sclerotherapy and those who were treated with surgical excision.

Of 492 patients with VMs treated between July 2011 and August 2020 at a single medical center for vascular anomalies, 63 patients diagnosed with IMVM were retrospectively reviewed. Pain, movement limitations, swelling, and quality of life (QOL) were evaluated subjectively, while radiological outcomes were assessed by qualified radiologists at the center. Complication rates were also evaluated, and radiological and clinical examinations were used to determine which treatment group (sclerotherapy or surgical excision) exhibited greater improvement.

Although there were no significant differences in pain (P=0.471), swelling (P=0.322), or the occurrence of complications (P=0.206) between the two treatment groups, the surgical treatment group exhibited significantly better outcomes with regard to movement limitations (P=0.010), QOL (P=0.013), and radiological outcomes (P=0.017). Moreover, both duplex ultrasonography and magnetic resonance imaging showed greater improvements in clinical outcomes in the surgical excision group than in the sclerotherapy group.

Although several studies have examined IMVM treatment methods, no clear guidelines for treatment selection have been developed. Based on the results of this study, surgical excision is strongly encouraged for the treatment of IMVMs.

• Intramuscular venous malformation
• Sclerotherapy
• Surgery

Various treatments for oral vascular malformation (VM) have been reported. Polidocanol and absolute ethanol have also been reported for sclerotherapy. However, there are still few reports on the therapeutic effect and dosage of polidocanol sclerotherapy. Therefore, we examined its therapeutic effects on oral VM. There were 17 sites of VMs, with nine patients diagnosed with oral VM at the Department of Dental and Oral Surgery, Tsukuba University Hospital. The medical records were retrospectively investigated to determine the site, hemangioma volume, polidocanol injection volume, and therapeutic effect. The volume of hemangiomas was calculated using magnetic resonance images. Based on the site, oral VMs were observed in the tongue, buccal mucosa, lips, and oral floor in eight, three, five, and one patients, respectively. The average size of the site was 3071 mm³. The average injection dose of polidocanol at one site was 2.86 mL, the average number of administrations was 1.6, and the response rate was 88.2%. No adverse events were observed. The median numerical rating scale scores were 2/10 (0–6/10) and 0/10 (0–1/10) the day after surgery and 1 week after surgery, respectively. Univariate regression analysis of the total dose in successful cases provided the following formula: 1.3 + 0.00025 × volume (mm³) (mg). Polidocanol sclerotherapy is an effective treatment method for oral VM.

• oral vascular malformation (VM)
• polidocanol
• sclerotherapy

• DCE-MRI
• sclerotherapy
• venous malformations

• Low-flow vascular malformations
• Lymphatic malformations
• Phlebography
• Sclerotherapy
• Venous malformations

• Adolescent
• Adult
• Child
• Child, Preschool
• Cross-Sectional Studies
• Female
• Humans
• Lymphatic Abnormalities/diagnostic imaging
• Lymphatic Abnormalities/physiopathology
• Lymphatic Abnormalities/therapy
• Male
• Middle Aged
• Phlebography
• Regional Blood Flow
• Retrospective Studies
• Sclerosing Solutions/adverse effects
• Sclerosing Solutions/therapeutic use
• Sclerotherapy/adverse effects
• Time Factors
• Treatment Outcome
• Vascular Malformations/diagnostic imaging
• Vascular Malformations/physiopathology
• Vascular Malformations/therapy
• Veins/abnormalities
• Veins/diagnostic imaging
• Veins/physiopathology
• Young Adult

• management
• pediatric
• slow-flow
• ultrasound
• vascular malformation
• venolymphatic
• venous

• Venous malformation
• coagulation
• sclerotherapy
• surgery
• venous thromboembolism

The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety, and systematizing treatment, employing evidence-based medicine (EBM) techniques and aimed at improvement of the outcomes. Clinical questions (CQs) were decided based on the important clinical issues. For document retrieval, key words for literature searches were set for each CQ and literature published from 1980 to the end of September 2014 was searched in Pubmed, Cochrane Library, and Japana Centra Revuo Medicina (JCRM). The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System (MINDS) technique. A total of 33 CQs were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy, and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence-based guidelines for the management of vascular anomalies.

• Clinical practice
• Guidelines
• Hemangioma
• Vascular anomalies
• Vascular malformation

• Age Factors
• Embolization, Therapeutic
• Evidence-Based Medicine/methods
• Hemangioma/therapy
• Humans
• Japan
• Laser Therapy/methods
• Sclerotherapy
• Time Factors
• Vascular Diseases/therapy
• Vascular Malformations/classification
• Vascular Malformations/therapy

• Adult
• Angiography
• Child
• Female
• Magnetic resonance imaging
• Pain
• Sclerosing solutions
• Sclerotherapy
• Vulva

The objective was to prepare guidelines to perform the current optimum treatment by organizing effective and efficient treatments of hemangiomas and vascular malformations, confirming the safety and systematizing treatment, employing evidence‐based medicine techniques and aimed at improvement of the outcomes. Clinical questions (CQ) were decided based on the important clinical issues. For document retrieval, key words for published work searches were set for each CQ, and work published from 1980 to the end of September 2014 was searched in PubMed, Cochrane Library and Japana Centra Revuo Medicina databases. The strengths of evidence and recommendations acquired by systematic reviews were determined following the Medical Information Network Distribution System technique. A total of 33 CQ were used to compile recommendations and the subjects included efficacy of resection, sclerotherapy/embolization, drug therapy, laser therapy, radiotherapy and other conservative treatment, differences in appropriate treatment due to the location of lesions and among symptoms, appropriate timing of treatment and tests, and pathological diagnosis deciding the diagnosis. Thus, the Japanese Clinical Practice Guidelines for Vascular Anomalies 2017 have been prepared as the evidence‐based guidelines for the management of vascular anomalies.

• clinical practice
• guidelines
• hemangioma
• vascular anomalies
• vascular malformation

• clinical practice
• guidelines
• hemangioma
• vascular anomalies
• vascular malformation

• percutaneous sclerotherapy
• polidocanol
• ultrasound guidance
• venous malformations

• Arteriovenous Malformations/therapy
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Male
• Polidocanol/administration & dosage
• Retrospective Studies
• Sclerosing Solutions/administration & dosage
• Sclerotherapy/adverse effects
• Sclerotherapy/methods
• Sclerotherapy/statistics & numerical data
• Ultrasonography, Interventional

Treatment for venous malformations of the head and neck includes sclerotherapy, surgical resection, or a combination of both. Surgical resection can remove or reduce the volume of vascular lesions; however, surgery can cause postoperative scarring and potential surgical complications. This study sought to determine the effectiveness of surgery for the treatment of venous malformations of the head and neck.

A retrospective review of the medical records of patients who received surgeries for venous malformations of the head and neck from January 2011 to July 2019 was performed. Using clinical photographs, preoperative and postoperative Doppler ultrasonography, outpatient clinic records, and operation records, the postoperative result and complications were evaluated for each case.

Among patients who visited our vascular anomalies clinic, 43 patients (ratio of male to female= 24:19) received surgeries for venous malformations of the head and neck. Twenty-nine patients had undergone surgery only, five patients received sclerotherapy after surgery, and nine patients received surgery after preoperative sclerotherapy. In postoperative evaluations, the result was excellent in 24 patients, good in 18 patients, and poor in one patient. Four patients experienced a recurrence of lesions with lagophthalmos, drooping of the corner of the mouth, partial wound necrosis, and scar widening found in one patient each.

Because the head and neck region is the most exposed area in the body, more active implementation of surgical treatments with or without sclerotherapy is essential to reduce the functional and cosmetic impairments associated with venous malformations.

• Head
• Neck
• Surgery, plastic
• Vascular malformations

• Head
• Neck
• Sclerotherapy
• Surgery
• Vascular malformations

• arteriovenous malformations
• digital subtraction angiography
• draining vein
• embolic
• maxillofacial region

• Intramuscular
• Sclerotherapy
• Venous malformations

• polidocanol
• sclerotherapy
• ultrasonography
• venous malformation

• Adolescent
• Adult
• Child
• Drug Administration Schedule
• Female
• Humans
• Male
• Polidocanol
• Polyethylene Glycols/administration & dosage
• Retrospective Studies
• Sclerosing Solutions/administration & dosage
• Sclerotherapy/methods
• Ultrasonography, Interventional
• Vascular Malformations/diagnostic imaging
• Vascular Malformations/therapy
• Young Adult

• interventional radiology
• sclerotherapy
• venous malformation

• Angioma
• Cavernous
• Hemangioma
• Sclerosant
• Sclerotherapy
• Vascular malformation
• Venous malformation

• ethanol
• radiofrequency ablation
• sequential combined treatment
• venous malformation

• Magnetic resonance
• sclerotherapy
• ultrasound (US)
• venous malformations (VM)

• Adults
• Children
• Localized intravascular coagulopathy
• Magnetic resonance imaging
• Morphology
• Phleboliths
• Venous malformation