Multimodality Image-Guided Sclerotherapy of Low-Flow Orbital Vascular Malformations: Report of Single-Center Experience

Samer Harmoush, Ponraj Chinnadurai, Kamel El Salek, Zeyad Metwalli, Honey Herce, Amit Bhatt, Paul Steinkuller, Timothy Vece, Shakeel Siddiqui, Ashwin Pimpalwar, Douglas Marx, Michel Mawad, Sheena Pimpalwar

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6 Scopus citations

Abstract

Purpose To evaluate the role of multimodality imaging tools for intraprocedural guidance and outcome evaluation during sclerotherapy of low-flow orbital vascular malformations. Materials and Methods A retrospective review was performed of 17 consecutive patients with low-flow orbital malformations (14 lymphatic, two venous, and one venolymphatic) who underwent multimodality image-guided sclerotherapy between November 2012 and May 2015. Sclerotherapy technique, image guidance tools, and complications were recorded. Sclerotherapy outcome was evaluated using clinical response, magnetic resonance (MR) image-based lesion volumetry, and proptosis quantification. Results There were 22 sclerotherapy sessions performed. Intraprocedural ultrasound (US), fluoroscopy, cone-beam computed tomography (CT) and MR image fusion were used for image guidance with 100% technical success. Resolution of presenting symptoms was observed in all patients at 1-month follow-up. Four major sclerotherapy complications were successfully managed. Statistically significant reduction in lesion volume (P =.001) and proptosis (P =.0117) by MR image analysis was achieved in all patients in whom 3-month follow-up MR imaging was available (n = 13/17). There was no lesion recurrence at a median follow-up of 18 months (range, 8-38 mo). Conclusions Multimodality imaging tools, including US, fluoroscopy, cone-beam CT, and MR fusion, during sclerotherapy of low-flow orbital malformations provide intraprocedural guidance and quantitative image-based evaluation of treatment outcome.

Original languageEnglish (US)
Pages (from-to)987-995.e4
JournalJournal of Vascular and Interventional Radiology
Volume27
Issue number7
DOIs
Publication statusPublished - Jul 1 2016
Externally publishedYes

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Keywords

  • Abbreviations DAP dose area product
  • IOP intraocular pressure
  • STS sodium tetradecyl sulfate

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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