# Short-Term Outcome of Foam Sclerotherapy With Sodium Tetradecyl Sulphate for the Treatment of Venous Malformation in Dhaka, Bangladesh: A Single-Centre Experience

## TL;DR

This study shows that foam sclerotherapy using sodium tetradecyl sulfate is an effective and low-risk treatment for venous malformations, with most patients experiencing significant symptom improvement.

## Contribution

The paper presents a single-centre experience in Bangladesh demonstrating the effectiveness of foam sclerotherapy for venous malformations in a local context.

## Key findings

- Swelling and pain decreased in all participants following sclerotherapy.
- 66.7% of participants achieved ≥50% lesion reduction, with 23.8% showing complete resolution.
- The treatment was associated with a low complication rate and allowed patients to return to daily activities immediately.

## Abstract

Background: Treatment of venous malformations is challenging for physicians. Previously, surgery was regarded as the only treatment option. Recently, sclerotherapy has been proven to be a low-cost, effective, and convenient substitute with minimal discomfort and blood loss. It doesn’t require local anaesthesia or postoperative care, allowing for immediate return to daily activities. This paper objectives to account for a single-centre experience with the use of foam sclerotherapy using sodium tetradecyl sulfate (STS) for venous malformations and to present the short-term clinical outcome, including symptom improvement, safety, and size reduction.

Methods: A prospective study was conducted in the Vascular Surgery Department, Bangladesh Medical University (BMU) between July 2021 to December 2021. We selected 21 patients with low-flow venous malformations confirmed by magnetic resonance imaging (MRI) and duplex ultrasonography. All the patients received STS foam sclerotherapy after clinical and radiological assessment. Each lesion received multiple sessions. A follow-up was done for radiological and clinical improvement of the lesions.

Result: The median age of the participant was 17 (12, 29) years. Around half of the participants (n=9; 42.9%) were from the 11-20 years of age group, with almost a similar sex distribution. Both upper and lower limbs were the most commonly affected regions (n=9, 42.9%; in each limb). Swelling was observed in all participants, and 16 presented with pain. After sclerotherapy, swelling and pain decreased in all participants (100%). A total of nine (42.9%) participants required three sessions of sclerotherapy, followed by eight (37.2%) patients who required four sessions. Several sessions of 3-4 ml of STS were required by 38.1% (n=8) participants, followed by 33% (n=7) requiring 2-2.9 ml/session. All participants experienced pain following sclerotherapy. While 14 (66.7%) of the participants obtained ≥50% response, among them five (23.8%) were completely reduced. The other seven (33.3%) cases resulted in <50% resolution.

Conclusion: Overall, STS sclerotherapy is an effective treatment procedure for low-flow venous malformations with a low complication rate. Moreover, it offers a convenient and cost-effective outpatient-based treatment option to most patients with uncomplicated venous malformations.