Percutaneous sclerotherapy of foot venous malformations: Evaluation of clinical response

•Treatment of foot venous malformations is a challenge due to their diffuse nature.•Percutaneous sclerotherapy is an effective treatment option.•Patients reported decrease in swelling and pain, and improvement of foot function.•Self limited post-procedural skin complications occur after 21% of the procedures.•A shorter lesion to skin surface distance was related to higher complications.

AimTo evaluate a single institutional experience with percutaneous sclerotherapy of venous malformations (VM) of the foot.Materials and methodsSixteen patients (mean age 14.6 years; range 6–27.3 years), who underwent 34 sclerotherapy procedures were retrospectively analysed. Technical success, Puig classification, VM size reduction, and the complication rate were evaluated. In procedures in which C-arm computed tomography (CT) was performed, the VM-to-skin surface distance was measured. Additionally, an e-mail-based questionnaire to evaluate the response to sclerotherapy was answered by the patients.ResultsTechnical success was 97%. The mean number of procedures per patient was 2.1 (range 1–5). In all procedures, sodium tetradecyl sulphate foam was used. Appropriate follow-up was available for 29/33 procedures (88%). Post-procedural complications occurred after 6/29 procedures (21%), all of which were self-limited skin complications. C-arm CT was performed in 19/33 procedures (58%). The lesion-to-skin surface distance was significantly shorter in patients with skin post-procedural complications (p < 0.001). The e-mail-based questionnaire was completed by 13/16 patients (81%). Decrease in swelling, improvement of foot function and a significant decrease in pain (p = 0.003) was reported. No patient reported dis-improvement after sclerotherapy.ConclusionPercutaneous sclerotherapy is an effective option for treating foot VMs. Skin complication rates are higher with shorter VM-to-skin surface distance.