Sclerotherapy

What Is Sclerotherapy?

Sclerotherapy (sklair-oh-THAIR-uh-pee) is a procedure to close blood vessels and lymph vessels. Doctors do this by injecting a solution into the vessel. The solution irritates the vessel's lining, making it collapse and stick together, sealing the vessel.

Interventional radiologists do sclerotherapy. They're doctors trained to use imaging (such as X-rays or ultrasound) to diagnose and treat problems with the blood and lymph vessels.

What Does Sclerotherapy Treat?

Doctors use sclerotherapy to treat problems with blood vessels or lymph vessels known as vascular anomalies.

Blood vessels are thin tubes that take blood cells, nutrients, and oxygen to the tissues throughout the body. They also take waste and carbon dioxide away from the tissues.

Lymph vessels are vein-like structures that help carry lymph throughout the body. Lymph is a clear fluid that carries fats, helps fight germs, and keeps the body's fluid levels normal.

What Are the Types of Vascular Anomalies?

Vascular anomalies include:

• port-wine stains
• venous malformations 
• arteriovenous malformations
• lymphatic malformations
• angiofibromas, bumps on the face seen in people with tuberous sclerosis
• glomangiomas, clusters of blood vessels and muscle 
• hemangiomas

Some happen deep inside the body and can't be seen. Others form a mark just under or on the skin. Doctors might treat ones that:

• are seen on the skin
• cause pain
• bleed
• press on an important body part, such as the windpipe or eye

How Is a Sclerotherapy Done?

Interventional radiologists do sclerotherapy in an interventional radiology suite (IR suite). This is like an operating room with extra X-ray and ultrasound equipment.

Before the procedure, a doctor or nurse puts in an intravenous (IV) line. Then the anesthesiologist gives medicine through the IV so the child sleeps through the procedure.

Then, the interventional radiologist will:

1. Take X-rays and/or ultrasound images to find the vascular anomaly.
2. Guide the tip of a needle into the vessels to be treated.
3. Put the solution through the needle into the vessels.
4. Check blood flow to be sure sclerotherapy sealed the vessels.
5. Remove the needle.
6. Sometimes if a malformation is large, the doctor will leave a catheter in it to repeat treatment over the next few days.

What Happens After Sclerotherapy?

After sclerotherapy, kids go to the recovery area to rejoin their family. Most can go home later the same day. A child may have pain and bruising where the vessels were closed for a few days after the procedure.

Are There Any Risks From Sclerotherapy?

Sclerotherapy usually is safe, but has some risks. Sometimes the vessel doesn't close or the wrong vessel closes. A child also might have:

• skin changes such as blistering or scarring over the area where the procedure was done
• infection where the needle was put in
• a slight increase in cancer risk because X-rays are used

The interventional radiologist will review all risks before the procedure.

How Can Parents Help?

Parents can help a child ready for sclerotherapy and recover after it:

• Follow any instructions the interventional radiology team gives you.
• Give your child pain medicine as needed and as prescribed.
• Ask about any instructions that are not clear.
• Take your child to all follow-up doctor visits.

During recovery, help your child to:

• Rest and get good sleep.
• Avoid strenuous activities.
• Walk daily.
• Avoid soaking the catheter site in a bath or pool.
• Eat and drink liquids as tolerated.