NOVA Families recieve free medial consultations at the NOVA Family Conference

This information was provided by the Department of Radiology, Children's Hospital of Boston.  The medical center has one of the most comprehensive Vascular Anomalies Centers in the World.  The VAC is directed by Dr. John Mulliken and Dr. Steven Fishman. 

Sclerotherapy is procedure used to treat certain types of vascular malformations. A medicine, called a sclerosant, is directly injected into an abnormal blood vessel. This causes clotting and shrinkage of the blood vessel. Sometimes malformations can enlarge again and sclerotherapy may be done in stages. The procedure usually takes 3 to 4 hours.

Sclerotherapy is used to reduce the size of vascular malformations.

• Sclerotherapy is a safe treatment for some types of vascular malformations.
• Sometimes there are side effects, such as blisters, nerve injury and numbness. Patients usually recover without problems.
• There is a very small chance that a blood clot will travel to the heart or lungs.
• The doctor will explain everything in detail when you give permission for the procedure.

A doctor, called an interventional radiologist most often performs sclerotherapy with the assistance of a trained radiology team.

Before the Procedure

Sclerotherapy is performed on adults and children.  It is generally peformed as an out-patient.  When you arrive at the hospital the radiologist will meet with you to discuss the specifics of your procedure and to sign consent forms.  You will change into a hospital gown and will be brought to the prodedure room where the sclerotherapy will be performed.  A nurse will start an IV.  Many children's hospitals will use a numbing cream before starting the IV. You may want to discuss this with your doctor in advance.  A medication will be given throught the IV to help you relax.  Parents are often allowed in the room until the child is asleep.

During the Procedure

Your skin  will be cleaned with a special liquid that helps prevent infection. Next the doctor inserts a needle into the malformation. The needle is first used to give a solution called contrast material. When contrast material is injected, the doctor can see clearly where to inject the sclerosant, using special x-ray equipment. Then the doctor injects sclerosant medicine into the malformation. This may be done once or many times, as needed.   Once the procedure is completed the needles will be removed and the nurse will applie an antibiotic cream and bandage to the area.

After the Procedure

Once you have begun to wake up, a nurse will take you to the Post Anesthesia Care Unit (PACU) or recovery area.  The nurse will watch you carefully for 4-6 hours.  Parents can join their child at this time.  You will be given fluids and pain medications through the IV.  Your urine may be red for several hours after this procedure.  You may begin to notice swelling and bruising in the area injected.

The healing process takes several weeks and even months.  At first there will be swelling and bruising.  It will reduce in a few days but will not go away completely for several weeks.  The veins that were injected now have blood clots in them.  Once these clost are absorbed by the body the swelling will go away.  The bruising may fade very quickly.  Some patients do get small blisters on the skin or a sore develops.  Keep these areas clean and dry.  Make sure you tell your doctor about any blisters or sores.  There will be locallized pain in the area, this can last 2-3 months.

NOVA PROVIDES THIS INFORMATION TO FAMILIES AS A RESOURCE. IT IS NOT INTENDED TO ENGAGE IN THE PRACTICE OF MEDICINE OR TO REPLACE THE PHYSICIAN. NOVA DOES NOT CLAIM TO HAVE MEDICAL KNOWLEDGE. NOVA DOES NOT ENDORSE ANY PARTICULAR PHYSICIAN, TREATING FACILITY OR TREATMENT PROTOCAL. IN ALL CASES NOVA AND ITS BOARD OF DIRECTORS RECOMMENDS THAT YOU SEEK THE OPINION OF A PHYSICIAN EXPERIENCED IN THE MANAGEMENT OF HEMANGIOMAS AND VASCULAR MALFORMATIONS. 

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