Preoperative Epoxy Embolization Facilitates the Safe and Effective Resection of Venous Malformations in the Hand and Forearm.

Journal Article (Journal Article)

BACKGROUND: The standard of care for treatment of low-flow venous malformations (VMs) is percutaneous sclerotherapy. These lesions are seldom surgically resected, especially if the malformation is in an anatomically difficult location. Percutaneous sclerotherapy is safe and effective. However, the drawbacks to sclerotherapy are the need for repeated treatments and risks of skin ulceration, deep venous thrombosis, scarring/contractures, and nerve damage. Surgical resection can be difficult because of intraoperative bleeding, intraoperative lesional decompression, and difficulty in localization. METHODS: We describe our initial experience with 11 patients who underwent surgical resection of VMs located in the hand and forearm after preembolization of 27 total sites using n-butyl-cyanoacrylate or ethylene vinyl alcohol copolymer. RESULTS: Of the 11 patients treated, 5 had focal VMs, 3 had multifocal VMs, and 3 had diffuse VMs throughout the affected extremity. Four of the 5 patients with focal VMs were followed for at least 1 year, and no further treatment was required. All 3 of the patients with diffuse VMs have required ongoing treatment. No major functional impairments were reported, and there were no major procedure-related complications. CONCLUSIONS: Overall, embolization of the malformation before surgical resection facilitated localization, demarcation, and removal of the lesion.

Full Text

Duke Authors

Cited Authors

  • Holly, BP; Patel, YA; Park, J; Fayad, LM; Deune, EG; Mitchell, SE; Weiss, CR

Published Date

  • July 2017

Published In

Volume / Issue

  • 12 / 4

Start / End Page

  • 335 - 341

PubMed ID

  • 28644938

Pubmed Central ID

  • PMC5484447

Electronic International Standard Serial Number (EISSN)

  • 1558-9455

Digital Object Identifier (DOI)

  • 10.1177/1558944716669798


  • eng

Conference Location

  • United States