Meenakshi Radiology

Phone: +91 82485 90535
Address: Near New Bus stand, Tanjore

Slow Flow Venous Malformation – Embolisation

  • Meenakshi Radiology
  • Specialities
  • Slow Flow Venous Malformation – Embolisation

    • We welcome 

    Our first batch of DNB Radiology students in Meenakshi hospital, Tanjore

    Minimally invasive image-guided therapy for symptomatic venous malformations

    What is a Slow Flow Venous Malformation?

    Venous malformations (VMs) are congenital, abnormal, dilated venous channels with slow blood flow. They can cause progressive swelling, pain, disfigurement, functional impairment and complications like thrombosis, bleeding and ulceration.

     

    Indications

    • Pain or discomfort
    • Progressive enlargement
    • Functional impairment
    • Recurrent thrombosis (phleboliths)
    • Cosmetic deformity
    • Bleeding or ulceration
    • Failure or contraindication to surgery
    • Adjunct to surgery to reduce intraoperative bleeding

    Embolisation Technique – Step by Step

    SFVME

    01.Vascular Access

    1

    Percutaneous access (usually femoral vein) under ultrasound guidance.

    Jan

    02.Diagnostic Venography

    2

    Catheter navigation into the malformation and venography to define anatomy, extent and drainage.

    Jan

    03. Microcatheter Placement

    3

    Superselective catheterisation of the malformation nidus/venous lakes.

    Jan

    04.Embolic Agent Injection

    4

    Slow, controlled injection of sclerosant/embolic agent until stasis is achieved.

    Jan

    05.Post Embolisation Venography

    5

    To assess reduction in flow and adequate penetration.

    Jan

    COMMON EMBOLIC AGENTS USED

    • Ethanol (absolute or in/saline mixture)
    • Bleomycin sclerotherapy
    • Polidocanol / Sodium tetradecyl sulfate (STS)
    • Onyx (ethylene vinyl alcohol copolymer)
    • N-butyl cyanoacrylate (NBCA) glue (selected cases)
    • Choice depends on size of malformation, flow, location and operator preference.

    ADVANTAGES

    Minimally Invasive

    • No large incisions. shorter hospital stay. faster recovery.
    Repeatable & Safe
    • Can be repeated sessions with good safety profile.
    Reduces Lesion Size
    • Decreases volume and improves function and cosmesis.
    Symptom Relief
    • Reduces pain, swelling, discomfort and risk of complications.

    Adjunct To Surgery

    • Lowers intraoperative bleeding and recurrence rate.

    Contraindications

    • Uncorrectable coagulopathy
    • Severe cardiopulmonary instability
    • Allergy to contrast or sclerosant not manageable
    • Pregnancy (relative)
    • Active infection at access site (relative)
    • High flow arteriovenous malformation (may require different approach)

    Potential Complications

    • Pain, swelling, fever
    • Skin blistering or ulceration
    • Nerve injury (rare)
    • Deep vein thrombosis
    • Pulmonary embolism (rare)
    • Non target embolisation
    • Recurrence (may need repeat treatment)

    IMPORTANT POINTS

    • Procedure should be performed in experienced centers.
    • Multiple sessions are often required for large lesions.
    • Compression therapy post procedure helps symptom control.
    • Monitor for complications.

    Important Advice

    • Embolisation is the treatment of choice for symptomatic slow flow venous malformations, offering effective symptom control wito minimal morbidity. Individualised treatment planning and multidisciplinary care are essential for optimal outcomes.