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Sclerotherapy involves injecting a medication into the malformation, which can cause swelling, then shrinkage of the area. Either medication or a chemical such as pure alcohol is injected into the malformation, which can cause swelling, then shrinkage of the area. Although sometimes a single treatment can be sufficient, more commonly, sclerotherapy is repeated every 2-3 months until patients are happy with their results. The total number of treatments needed typically depends on how large the malformation is and its location. For example, if the malformation is on the face, it may be treated more aggressively than one within a thigh muscle.
Before the procedure, your child will be evaluated to ensure sclerotherapy is warranted. Depending on the nature and complexity of the vascular malformation, your child may be seen by a multidisciplinary team consisting of an interventional radiologist, surgeons, hematologists, or specialists. Sclerotherapy is performed with sedation, so your child will need to be fasting for an appropriate amount of time before treatment.
The procedure is performed in the Interventional Radiology room. Ultrasound and fluoroscopy (x-rays) are used to precisely target the malformation. A small needle injects the sclerosant into the puncture site after confirming the appropriate needle location. Rarely is anything other than a small needle needed for this treatment.
Expect some soreness and swelling for the first few days. The pain is handled with a combination of Tylenol and NSAIDs such as ibuprofen. Over the next 8-12 weeks, the malformation slowly shrinks and can be augmented by wearing a compression garment.
Slow flow vascular malformations are first noticed either at birth or in early childhood. Treatment varies and may include sclerotherapy or surgery.