Foam Sclerotherapy


Sclerotherapy is a procedure performed to treat vascular malformations.  Vascular malformation is the name given to describe several different types of abnormal links between blood or lymph vessels.

These malformations are usually present at birth and tend to grow as the child develops.  They are often asymptomatic (producing no symptoms) until adulthood.  They may grow more rapidly due to hormonal changes or trauma around the area.

There are 2 ways to perform foam sclerotherapy;

  1. Direct injection of malformation.
    1. This can involve multiple injections of foam using ultrasound to visualise the malformation.
  2. Intravascular injection of malformation.
    1. This requires a femoral artery/vein puncture. Small catheters are directed to the malformation where the foam is injected directly into the malformation.

Your treatment options will be discussed with you on the day of your consultation.

Why do I need this procedure?

Foam sclerotherapy is performed to eliminate the flow/communication of blood/lymph between these abnormal structures. It is a treatment that is performed to provide symptomatic relief of the malformation, especially pain and swelling.  It can also lighten areas of discoloration, especially on the face.  It can be performed multiple times if necessary or in conjunction with surgery (if applicable).

What should I expect?

  • The procedure can take between 60 – 90mins.
  • The contrast can cause a warm flushing or burning sensation. It only last for a few seconds and stops once the contrast has stopped being injected.  Please ring MIVIR if you have a known allergy to Iodine or contrast.
  • You may be required to take some time off work – please let the nurses know so they can organise a medical certificate for you. An attendance certificate can be provided for your carer on the day of the procedure.
  • Please make sure you have someone to pick you up after your procedure. You procedure will be cancelled if you don’t have an escort.  Please contact MIVIR as soon as possible if this cannot be arranged.
  • After the procedure you may experience mild-moderate discomfort which should resolve over the following few days. You should only require oral pain medication to help relieve symptoms.  Ice, rest and elevation can also provide relief.

On the day of your Procedure

You will need to present to the Day Procedure Unit on the day of your procedure – your admission time will be sent to you with your appointment time.  This will allow the nurses time to complete your admission paperwork and any other tests that may be required such as blood tests or pre-medication.

You will be required to fast for 4 hours before you procedure – this means no food or fluids.  You may take any regular medication with a small sip of water.  Please continue to take your blood pressure medication.  Please bring a list of your medications with you.

Please contact MIVIR if you are taking medication for the following;

  • Diabetes,
  • Stroke,
  • Heart Conditions such as a Heart Attack or Atrial Fibrillation.
Pre Procedure

Pre Procedure

You will be required to change into a hospital gown and remove all clothing including your underwear.  A cannula will be inserted into one of the veins in your arm or hand so medication can be given before, during or after your procedure.  You may need to have some hair removed from your groin crease.

Procedure

Procedure

You will be taken into the Angiography Suite and positioned on the table.  Monitoring equipment will be attached so the nurses can monitor your blood pressure and heart rate throughout the procedure.  The scrub nurse will clean the top of your leg with a cold antiseptic solution and then cover you with a sterile drape. Local anaesthetic will be injected into the skin, which will sting for 15-20 seconds.  You should only feel pushing and pressure after this.

Post Procedure

Post Procedure

Your recovery will vary depending on the type of procedure performed.  This should be explained to you during your admission.  Compression dressings are stocking may be required, this will be discussed with you during your consultation.   During your time in the recovery room the nurses will monitor your blood pressure and heart rate and regularly check the puncture site for any signs of bleeding.  You will be given something to eat and drink as soon as you are able to sit up.  Your cannula will be removed just before you leave the hospital.  If you are staying overnight in the hospital, you will be taken to the ward after a short period in recovery.

Discharge

Discharge

If you are being discharged home, your recovery period is approximately 4 hours.  You must have someone to collect you and stay with you overnight.  You will be given a letter from the nurses with some discharge instructions and any other relevant information related to your procedure.  You may be required make a follow-up appointment with Dr Vrazas.  This can be made at your convenience by phoning MIVIR on 9411 7165.

At Home

At Home

We recommend the following;

  • Do not remove pressure dressing or Anti-embolic stockings for ___ days/weeks.
  • You rest quietly at home (do not undertake vigorous exercise) for the next 24 hours.
  • We recommend you walk daily for approximately 30 minutes.
  • Ice and/or elevation may ease any discomfort you may have.
  • A mild oral analgesic for any pain or discomfort you experience in the days following your procedure.
  • You contact MIVIR or present to the nearest Emergency Department if you notice any of the following;
    • Increasing redness or swelling at the puncture site,
    • Increasing/persistent pain at puncture site, not relieved with mild analgesia or rest,
    • Bleeding or ooze not stopped with gentle pressure or elevation,
    • Any changes to skin appearance including skin breakdown, blistering or any discharge,
    • Fever,
    • Generally feeling unwell.

Useful Links

http://www.virginia.edu/uvaprint/HSC/pdf/14070.pdf