Arch Plast Surg.
2021 Nov;48(6):622-629. 10.5999/aps.2021.00913.
The effects of surgical treatment and sclerotherapy for intramuscular venous malformations: a comparative clinical study
- Affiliations
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- 1Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
- 2Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea
- 3Vascular Anomalies Center, Kyungpook National University Hospital, Daegu, Korea
- 4Department of Radiology, School of Medicine, Kyungpook National University, Daegu, Korea
- 5Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
- 6Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea
- 7Cell and Matrix Research Institute, Daegu, Korea
- 8BK21 FOUR KNU Convergence Educational Program of Biomedical Sciences for Creative Future Talents, School of Medicine, Kyungpook National University, Daegu, Korea
- KMID: 2522409
- DOI: http://doi.org/10.5999/aps.2021.00913
Abstract
- Background
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.
Methods
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.
Results
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.
Conclusions
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.
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