Sclerotherapy is a 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. Why is it necessary? Sclerotherapy is used to reduce the size of vascular malformations and/or take care of any associated symptoms. Is it safe? 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. Who performs the procedure? A doctor, called an interventional radiologist, performs the procedure with the help of the interventional radiology team. How should I prepare my child? After you schedule your child’s procedure, you will be sent written instructions. These instructions tell you when your child must stop eating, drinking and taking medicine. Your child may receive general anesthesia to help him or her stay still during the procedure. General anesthesia is medicine that causes deep sleep. A doctor called an anesthesiologist will discuss this with you and obtain consent, either the day of the procedure or at a scheduled pre-operative visit. Explain in simple terms why the procedure is needed and what will happen. Some things you may want to say: you will be close by during the procedure, and your child may bring a favorite toy or blanket into the room. What happens before the procedure? A staff person from Admitting, Day Surgery, or Preoperative Clinic will call you a few days before the procedure to tell you where to go when you come to the hospital. When you arrive, the interventional radiologist will talk with you about the procedure and ask you to sign a consent form. You must be your child’s legal guardian to sign this form. If you are a legal guardian and not a parent, you must bring legal paperwork with you showing proof of legal guardianship. Your child will change into a hospital gown. A nurse will start an intravenous (IV). Then you and your child will be brought into the room where the procedure is done. The nurse will give some medicine through the IV to help your child relax. You may stay until your child falls asleep. If your child is young, he/she may go to sleep with medicine and a mask. You will be waiting in a special area until your child’s procedure is done and he/she is settled in the post-anesthesia care unit (PACU). What happens during the procedure? The radiology technologist cleans the skin 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 neede. When the procedure is done, the needles are removed. The nurse applies an antibiotic ointment and bandage. What happens after the procedure? When your child starts to wake up, a nurse takes him or her to the Post Anesthesia Care Unit (PACU). He or she is watched closely for 4 to 6 hours. You may stay with your child. Your child will receive fluids and pain medicine through the IV. Your child may have red urine for several hours. The areas that were injected are usually very swollen and bruised. The interventional radiologist or interventional radiology nurse practitioner will speak to you about the results. How long will recovery take? The healing process usually takes several weeks to months. At first, there is swelling and bruising. The swelling reduces over the first 24 to 48 hours. It does not go away completely until the blood clots are absorbed. This may take up to 2 months. The bruising fades gradually. If the skin is involved in the vascular malformation, there may be a blister or sore. Expect your child to feel some pain as the area heals. Pain may last 2 to 3 months. The doctor or nurse practitioner will prescribe pain medication. Give this pain medicine as prescribed and instructed by your doctor and nurse. Where can I call for more information? Call the Interventional Radiology Office at (617) 355-6579 if you have any questions or concerns. You may ask to speak with a doctor, nurse practitioner, or nurse.
