Real-time MRI-guided percutaneous sclerotherapy treatment of venous low-flow malformations in the head and neck

Sasan Partovi, Ziang Lu, Lorenna Vidal, Dean A. Nakamoto, Ji Buethe, Michael Coffey, Indravadan J. Patel

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This manuscript describes the technique of real-time MRI-guided sclerotherapy for low-flow venous malformations in the head and neck based on our institutional experience. Materials and methods: Ethanolamine oleate is used as the sclerosant and is mixed with gadolinium for visualization during the procedure. The five procedural steps include: (I) an initial tri-plane T2-weighted sequence to visualize the lesion; (II) a T1 FSE or trueFISP sequence to assess needle placement and advancement within the lesion; (III) a tri-plane T1 FLASH sequence to monitor sclerosant injection; (IV) a T1 FSE or VIBE sequence to assess sclerosant coverage of the malformation before needle removal; (V) a post-procedural tri-plane T1 fat-saturated sequence to confirm sclerosant coverage of the lesion. Periprocedural medications typically include steroids, antibiotic prophylaxis, and non-steroidal anti-inflammatory medication. Patients are typically admitted for overnight observation. Conclusion: Real-time MRI-guided sclerotherapy for low-flow venous malformations in the head and neck is effective and safe.

Original languageEnglish (US)
JournalPhlebology
DOIs
StateAccepted/In press - Jan 1 2017

Keywords

  • Ethanolamine Oleate
  • MRI guidance
  • percutaneous sclerotherapy
  • real-time
  • Venous malformation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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