Ultrasound-guided Endovenous Diode Laser in the Treatment of Congenital Venous Malformations: Preliminary Experience

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The authors present their experience in treating congenital venous malformations with ultrasound (US)-guided endovenous diode laser. Six patients underwent treatment of eight venous malformations for complaints including pain, activity limitation, or cosmetic defect. At a mean follow-up interval of 14.5 months, all had either resolution of (five patients) or marked decrease in (one patient) pain, allowing them to resume previously limited activities. There were no instances of nerve damage or skin necrosis. One patient had a self-limited mucosal tongue base ulcer. In this small series of patients, endovenous laser treatment of venous malformations was effective during short-term follow-up.

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MATERIALS AND METHODS

After obtaining institutional review board approval, we retrospectively reviewed the records of all patients who began ultrasound guided endovenous laser treatment of VM at our institution between August 2002 and August 2003.

Procedure Success

A total of 17 procedures were performed for eight lesions in six patients. All procedures were technically successful. A mean of 2.1 treatment sessions was required per lesion. The mean interval between sessions was 4.1 months. A mean of 3.6 laser passes were performed at each treatment session.

Follow-up

Follow-up time was calculated from last laser procedure performed and ranged from 0 to 25 months, with a mean of 14.5 months. All lesions decreased in size after laser treatment, by patient report (three

DISCUSSION

Venous malformations can cause pain and swelling in patients and can lead to activity limitation in otherwise young and healthy patients. VM are usually single but can be multiple, can occur anywhere in the body, and in up to two-thirds of patients, can infiltrate along neurovascular distributions (10). They may be associated with a variety of syndromes and, in these, mutations have been identified in genes that control smooth muscle and endothelial cells (2). Current treatments, including

CONCLUSIONS

In this small series of patients treated with US-guided endovenous diode laser of venous malformations, there was improvement or resolution of the presenting symptoms in all patients and a decrease in size of all lesions seen, with minimal morbidity. Our early experience suggests that endovenous diode laser therapy is an effective treatment with minimal morbidity. Future prospective studies including more standardized clinical, photographic and imaging follow-up will be useful to further define

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Presented at the 2004 SIR Annual Meeting.

None of the authors has identified a potential conflict of interest.

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