Sclerotherapy

Sclerotherapy is a common procedure used to treat vascular malformations. Vascular malformations are abnormal clusters of blood vessels or cysts that can develop before or after birth. Some malformations cause no problems, but others can affect blood flow, cause disfigurement, pain, swelling or bleeding.
They can appear as a cluster of abnormal veins, known as a venous malformation, or, as small or large cysts, known as lymphatic malformation.

Sclerotherapy treatment involves injections of a sclerosing medication into the affected areas using small needles and catheters. Ultrasound and X-rays are used to guide an interventional radiologist who does the procedure. It usually takes around 1 hour to complete and is performed under a general anaesthetic.

The treatment aims to reduce the size, pain or improve appearance or function.

Why does my child need sclerotherapy?

The decision to use sclerotherapy is based on the signs and symptoms your child has including pain, appearance and the function of the affected area. The type of treatment your child will receive depends on the location, size and type of vascular malformation.

Preparing for the procedure

It’s important that your child is healthy on the day of the procedure. Your child’s stomach must be empty for the procedure and you’ll need to discuss any special needs your child has with your doctor, including if they are taking any medications. You will be contacted by a health professional from Medical Imaging a few days before your procedure to discuss these details, including fasting and arrival times.

One week before

• Talk to your doctor about any special needs or medications your child is currently taking.
• Make sure you understand what your child is required to do before the treatment.
• Talk to your child about what will happen. Children feel less anxious and supported when they know what to expect. They also feel assured with their parents are calm and supportive.

The day before

• Ensure you understand and follow the strict times provided for when to stop eating and drinking.

What to expect

Your child will have a general anaesthetic for the treatment. They will usually need to stay at the hospital for the whole day and occasionally overnight.

On the day of the procedure, you’ll be able to speak to the interventional radiologist who will do the sclerotherapy, and the anaesthetist, before the treatment.

During the sclerotherapy, you will be asked to wait in the waiting area, but once the procedure is complete your child will be moved to the recovery ward, where you can be with them.

After the procedure, the area that was treated may be swollen, sore and appear bruised. This usually improves over 1-2 days. You should see a gradual improvement over 1–2 weeks.

An occupational therapist may apply a compression bandage to the area that was treated. If it’s needed, they will talk to you about how to care of this and how long it should be worn.

Care at home

If your child can take them, you can use paracetamol and ibuprofen to help manage any pain at home.

If your child has compression bandage, their occupational therapist or nurse will explain how to care for it, when it can be removed, or, when it can be used.

Your child can resume normal daily activity, including returning to school, when they feel well enough. Any contact sports should be avoided for 2 weeks.

Your child should be able to shower/bath normally at home.

When to seek medical assistance?

Sclerotherapy is generally safe for children. Your child’s healthcare team will talk to you about what to look out for and when to contact us or your GP for advice or review.

If you notice the following, please take your child to nearest emergency department or your GP:

• bleeding from the area
• severe and worsening redness swelling
• fever or pain which doesn’t improve with paracetamol and/or ibuprofen
• skin blisters, ulceration or blackened skin.

Follow up

Your child will be reviewed at an outpatient clinic or via a phone consultation.

It usually takes about two to three months to see the full effect of the treatment

It’s common for a child to require several treatments over a year or two. If that’s the case, your child’s healthcare team will discuss this with you.

Key points

• Sclerotherapy is a common procedure used to treat vascular malformations.
• It usually takes about 2 to 3 months to see the full effect of the treatment
• Your child can resume normal activity as soon as they are well enough and feel comfortable, though contact sports should be avoided for 2 weeks.

Developed by Vascular Anomalies Clinic and Medical Imaging Department, Queensland Children’s Hospital. We acknowledge the input of consumers and carers.

Resource ID: FS017. Reviewed: June 20217.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.