Sclerotherapy

When is sclerotherapy needed?

Sclerotherapy is used to reduce the size and decrease the symptoms associated with vascular malformations.

How does it work?

Guided by ultrasound and x-ray images, our interventional radiologist introduces a needle or a thin, hollow tube called a catheter into the vascular malformation. This is most often done through the skin (percutaneously), but other approaches are possible, depending on the location of the malformation. The sclerosant is injected through the needle or the catheter.

How should I prepare my child for the procedure?

Explain to your child in simple terms why the treatment is needed and what will happen. You can say that you will be close by and that he may bring a favorite toy or blanket into the procedure room.

What will happen before the sclerotherapy?

Someone from the hospital will call you a few days before the sclerotherapy to tell you where to go when you come to the hospital. The staff member will talk about when your child should stop eating, drinking and taking medicines.

Your child may need to visit the preoperative clinic, where he will meet with a nurse and an anesthesiologist and undergo any necessary laboratory tests. You and your child will then meet with the nurse practitioner in the Division of Interventional Radiology. Please plan on spending two to four hours at the hospital for the preoperative visit.

When you arrive at the hospital for the sclerotherapy:

• The interventional radiologist will talk to you about the procedure and ask you to sign the consent form. (You must be your child's legal guardian to sign this form. If you are a legal guardian and not a parent, you must bring the paperwork showing proof of legal guardianship.)
• Your child will change into a hospital gown.
• A nurse or anesthesiologist may start an intravenous (IV) line.
• Once your child is asleep, you will be escorted to a special waiting area.

 What happens during the procedure?

• The radiology technologist will clean the skin through which the needle will be guided with a special liquid that helps prevent infection.
• Under ultrasound or x-ray guidance, the needle or catheter is guided to the vascular malformation. The radiologist will then inject a special contrast solution through the catheter so that the vascular malformation can be seen more clearly.
• Several sites may be accessed during one procedure in order to most effectively treat the lesion.
• The radiologist then injects the sclerosant.
• When the procedure is done, the catheter is removed and a bandage is placed to prevent bleeding.

What happens after the procedure?

• Your child will be taken to the recovery room, where we will closely monitor him. You may be with your child in the recovery room.
• Depending on what sclerosant is injected, sclerotherapy very often causes the injected area to swell. While this rarely causes severe discomfort, all patients will receive medication for pain, as needed. The swelling may take up to two weeks to go away.
• The final evaluation of how much of the lesion has been successfully converted to scar may take up to six weeks. In most cases, several procedures are needed to completely treat a malformation.

How will I learn the results?

The interventional radiologist will speak with you after the procedure and explain the findings and results.

Is it safe?

Sclerotherapy is considered a minor surgical procedure. While it is generally safe, it can be potentially associated with serious side effects. The interventional radiologist will explain these to you in detail before obtaining your permission to perform the procedure.

During sclerotherapy, your child will be exposed to ionizing radiation (x-rays). While we always attempt to minimize exposure to x-rays, we believe that the benefit of treatment outweighs the exposure that occurs during the procedure. Because children are more sensitive to radiation exposure than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.