Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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The effects of surgical treatment and sclerotherapy for intramuscular venous malformations: a comparative clinical study

  • Kim, Yun Hyun (Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University) ;
  • Ryu, Jeong Yeop (Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University) ;
  • Lee, Joon Seok (Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University) ;
  • Lee, Seok Jong (Department of Dermatology, School of Medicine, Kyungpook National University) ;
  • Lee, Jong Min (Vascular Anomalies Center, Kyungpook National University Hospital) ;
  • Lee, Sang Yub (Vascular Anomalies Center, Kyungpook National University Hospital) ;
  • Huh, Seung (Vascular Anomalies Center, Kyungpook National University Hospital) ;
  • Kim, Ji Yoon (Vascular Anomalies Center, Kyungpook National University Hospital) ;
  • Chung, Ho Yun (Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University)
  • Received : 2021.05.25
  • Accepted : 2021.09.14
  • Published : 2021.11.15
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Abstract

Background Venous malformations (VMs) are the most common type of vascular malformations. Intramuscular venous malformations (IMVMs) are lesions involving the muscles, excluding intramuscular hemangiomas. The purpose of this study was to compare clinical outcomes between patients with IMVMs who were treated with sclerotherapy and those who were treated with surgical excision. Methods Of 492 patients with VMs treated between July 2011 and August 2020 at a single medical center for vascular anomalies, 63 patients diagnosed with IMVM were retrospectively reviewed. Pain, movement limitations, swelling, and quality of life (QOL) were evaluated subjectively, while radiological outcomes were assessed by qualified radiologists at the center. Complication rates were also evaluated, and radiological and clinical examinations were used to determine which treatment group (sclerotherapy or surgical excision) exhibited greater improvement. Results Although there were no significant differences in pain (P=0.471), swelling (P=0.322), or the occurrence of complications (P=0.206) between the two treatment groups, the surgical treatment group exhibited significantly better outcomes with regard to movement limitations (P=0.010), QOL (P=0.013), and radiological outcomes (P=0.017). Moreover, both duplex ultrasonography and magnetic resonance imaging showed greater improvements in clinical outcomes in the surgical excision group than in the sclerotherapy group. Conclusions Although several studies have examined IMVM treatment methods, no clear guidelines for treatment selection have been developed. Based on the results of this study, surgical excision is strongly encouraged for the treatment of IMVMs.

Keywords

Acknowledgement

This work was supported by a National Research Foundation of Korea (NRF) grant, funded by the Korean government (MSIT) (No. 2020R1A2C2009496).

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