What Is Sclerotherapy?
Sclerotherapy (sklair-oh-THAIR-uh-pee) is a procedure done by interventional radiology specialists. In it, they use a needle or a to squirt (inject) medicine into blood vessels or to make the vessel seal itself closed.
Why Is Sclerotherapy Done?
Interventional radiologists (specialists trained to do minimally invasive procedures) use sclerotherapy to treat abnormal clusters of blood vessels or vessels called vascular malformations.
Types of malformations include:
- port-wine stains
- venous malformations
- arteriovenous malformations
- lymphatic malformations
- angiofibromas (in patients with tuberous sclerosis)
Sclerotherapy may be done for vascular malformations that:
- are painful
- tend to bleed
- push on important blood vessels or airways and cause a blockage
- get in the way of activities
- get in the way of the child socializing or playing with friends because of how it looks
What Happens Before Sclerotherapy?
Before the procedure, the interventional radiologist will:
- examine your child
- study images of the vascular malformation
- make a treatment plan
- talk to you and your child about the vascular malformation and sclerotherapy
- describe the risks and likely benefits of sclerotherapy
- give you information so you can compare sclerotherapy with other ways to treat the problem
- answer your questions and your child's questions
If you decide that sclerotherapy is best for your child, you'll sign a consent (permission) form. The interventional radiology team will schedule the sclerotherapy and talk to you about:
- which medicines to give your child, and when to give them
- when your child should stop eating
- when to arrive for the procedure
- whether your child will stay in the hospital after the sclerotherapy
A few days before the sclerotherapy date, your child may:
- see an anesthesia team member to decide which anesthesia is best
- get some blood tests and urine tests done
How Is a Sclerotherapy Done?
An interventional radiologist does the procedure in a room called an interventional radiology suite (IR suite). The IR suite is like an operating room with extra X-ray and ultrasound equipment. The treatment team typically also includes:
- an anesthesiologist or anesthetist
- nurses and assistants
- technologists (equipment specialists)
Before taking your child into the IR suite, a team member will:
- ask your child to change into a hospital gown
- place an intravenous (IV) line in your child's vein
- put medicine into the IV so your child will feel sleepy
The anesthesiology team will take your sleeping child to the IR suite. For most sclerotherapy procedures, the interventional radiologist will then:
- get fresh X-ray images and videos and ultrasound scans to map the target vessels
- use X-ray images and videos to guide the tip of a needle into vessels to be treated with sclerotherapy
After injecting the sclerosing medicine (sclerosant), the interventional radiologist will check the blood flow to be sure the sclerotherapy blocked the vessels before removing the needle. If the sclerosant does not work, the doctor may use other methods to block the vessels.
Depending on the type of vascular malformation your child has, the doctor may place drainage tubes (catheters) in the treated area to reduce swelling.
Can I Stay with My Child During Sclerotherapy?
Parents may stay in the preparation area until their child goes to the IR suite. Then, you'll move to the waiting area. When the sclerotherapy is done, you may go to the recovery room while your child wakes from anesthesia.
How Long Does Sclerotherapy Take?
Most sclerotherapy procedures take about an hour. Complicated treatments may take several hours depending on the number, size, and location of the vessels to be treated.
What Happens After Sclerotherapy?
After the sclerotherapy, the treatment team will take your child from the IR suite to the recovery area. You can be there as your child wakes up. The interventional radiologist will:
- talk to you about how the procedure went
- tell you what to expect in the next few days
- answer any questions you have
Most children go home later the same day. For a few days after the sclerotherapy, your child may feel pain and have bruises where the target vessels were sclerosed.
Are There Any Risks From Sclerotherapy?
Anything that breaks the skin can lead to an infection. The interventional radiologist will go over these and other risks with you before the procedure:
- The sclerotherapy may not block the target vessels.
- The sclerosing medicine may block other vessels besides the target vessels.
- The sclerosing medicine may cause blistering, scarring, or loss of sensation in the skin over the target vessels.
- The skin over the target vessels may change color (called hyperpigmentation).
- Because sclerotherapy requires the use of X-rays, your child's lifetime risk of cancer is increased very slightly.
How Can I Help My Child Feel Better?
To help your child:
- Listen to, read, and 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 the recovery time, 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
Keep an eye out for:
- pain that doesn't go away with pain medicine
What If I Still Have Questions?
For non-urgent questions, call the clinic and talk with a staff member.
For urgent questions, use the emergency contact number given for the interventional radiology team.
When Should I Call the Doctor?
The interventional radiology team will tell you when to call or go to an emergency department. These are signs and symptoms of possible problems:
- fresh (bright red) blood on the groin bandage
- more pain, redness, or swelling than you or your child noticed while at the hospital
- fever — a temperature over 100.4°F (38°C)
- unusual sleepiness or unresponsiveness