REGULAR CONTENT
Final ID
576
Type
Original Scientific Research-Oral or Pos
Authors
S Hussain1, K Quencer1, T Ramchand1, S Rashid1, A Momin1, J Pollak1
Institutions
1Yale New Haven Hospital, New Haven, CT
Purpose
Plantar venous malformations (PVMs) are rare entities that are challenging to diagnose and detrimental to patients. PVMs are primarily considered congenital malformations that manifest clinically according to their location and severity. PVMs have been reported to present with pain, swelling, cutaneous ulceration, limb length discrepancies, or hemorrhage. The patients seen at our institution also presented with significant functional disability. We aim to report our experience with the clinical symptoms, imaging findings, and percutaneous treatments of PVMs.
Materials & Methods
On retrospective review, 10 patients with PVMs were identified. Their clinical presentation as well as all ultrasound, angiography, and MRI imaging findings were reviewed. Angiography results were utilized to confirm diagnosis. 9 of these 10 patients underwent image guided sclerotherapy. These 9 patients' treatment methods and one year post-procedural clinical outcomes were reviewed.
Results
10 (3 male, 7 female) patients with PVMs were identified at our institution between May '09 and March '15. The mean age at presentation was 20.4 years. All 10 patients presented with severe intermittent pain on the plantar aspect of their feet. 4/10 patients also presented with chronic pedal edema. Mean time from clinical presentation to diagnosis was 8.3 months. All patients underwent ultrasound evaluation and 9 out of 10 received an MRI. The most prevalent imaging findings were complex cystic masses and tortuous pedal vessels with weak/slow flow. Thrombus was identified in 5/10 patients. 9/10 patients underwent image guided sclerotherapy. 4/9 patients' symptoms resolved within 4 months after a single treatment, 3/9 patients required additional sclerotherapy sessions (2 & 3 sessions total) before symptoms resolved, and 2/9 patients opted for surgical excision after a single sclerotherapy procedure resulted in temporary relief (their pain returned after 6 and 8 months respectively).
Conclusions
PVMs are indeed a diagnostic challenge and result in significant functional disability. Our experience with 10 patients confirms that diagnostic imaging is essential in diagnosis and image guided sclerotherapy gives most patients symptomatic relief.
Final ID
576
Type
Original Scientific Research-Oral or Pos
Authors
S Hussain1, K Quencer1, T Ramchand1, S Rashid1, A Momin1, J Pollak1
Institutions
1Yale New Haven Hospital, New Haven, CT
Purpose
Plantar venous malformations (PVMs) are rare entities that are challenging to diagnose and detrimental to patients. PVMs are primarily considered congenital malformations that manifest clinically according to their location and severity. PVMs have been reported to present with pain, swelling, cutaneous ulceration, limb length discrepancies, or hemorrhage. The patients seen at our institution also presented with significant functional disability. We aim to report our experience with the clinical symptoms, imaging findings, and percutaneous treatments of PVMs.
Materials & Methods
On retrospective review, 10 patients with PVMs were identified. Their clinical presentation as well as all ultrasound, angiography, and MRI imaging findings were reviewed. Angiography results were utilized to confirm diagnosis. 9 of these 10 patients underwent image guided sclerotherapy. These 9 patients' treatment methods and one year post-procedural clinical outcomes were reviewed.
Results
10 (3 male, 7 female) patients with PVMs were identified at our institution between May '09 and March '15. The mean age at presentation was 20.4 years. All 10 patients presented with severe intermittent pain on the plantar aspect of their feet. 4/10 patients also presented with chronic pedal edema. Mean time from clinical presentation to diagnosis was 8.3 months. All patients underwent ultrasound evaluation and 9 out of 10 received an MRI. The most prevalent imaging findings were complex cystic masses and tortuous pedal vessels with weak/slow flow. Thrombus was identified in 5/10 patients. 9/10 patients underwent image guided sclerotherapy. 4/9 patients' symptoms resolved within 4 months after a single treatment, 3/9 patients required additional sclerotherapy sessions (2 & 3 sessions total) before symptoms resolved, and 2/9 patients opted for surgical excision after a single sclerotherapy procedure resulted in temporary relief (their pain returned after 6 and 8 months respectively).
Conclusions
PVMs are indeed a diagnostic challenge and result in significant functional disability. Our experience with 10 patients confirms that diagnostic imaging is essential in diagnosis and image guided sclerotherapy gives most patients symptomatic relief.