Dr Wayne F. Yakes (second, right), director of Yakes’s vascular malformations centre in the US, trains doctors at HCM City’s Gia Dinh People’s Hospital in using absolute ethanol to treat vascular malformations (Photo courtesy of the hospital) HCM City (VNS/VNA) - Patients with vascular malformations can beeffectively treated by using absolute ethanol, according to experts.
Dr Nguyen Dinh Luan, head of interventional radiology (IR) and deputy head ofthe department of radiology at the Gia Dinh People’s Hospital, said thesepatients used to go around looking for a cure in the past.
Surgery plays an important role in small, located and superficial vascularmalformations, but most of them are diffuse, ill surrounded and relate to bone,muscle or vital as well as functional organs, in which case surgery couldseriously harm the patient’s body, he said.
Interventional radiology nowadays plays an important role in the management ofvascular malformations. Various materials are used to embolise vascular malformations,including glue N-butyl cyanoacrylate (NBCA), onyx and sclerosant agents in thecase of neurovascular malformations.
Absolute ethanol is a destructible sclerotherapy or a minimally invasiveprocedure used to treat abnormal or enlarged blood vessels, usually varicoseveins.
An 18-21 gauge needle is inserted into the centre of the malformation andabsolute alcohol is injected directly into it.
Because of toxicity of pure alcohol to the human body, a limited amount ofalcohol should be used at a time. Thus, managing vascular malformation by usingalcohol is often divided into multiple sessions.
With help from Dr Wayne F. Yakes, director of Yakes’s vascular malformationscentre in Denver, the US, doctors at the Gia Dinh People’s Hospital have beenperforming this technique since 2016.
Yakes is considered the most experienced in the world in this technique afterpractising it for more than 30 years, and trains doctors all over the world.
On June 20 and 21, Yakes and the IR Unit at the hospital’s radiology departmentheld a workshop on treating vascular malformations, where 28 patients werechosen for management of the condition.
They included people with venous, capillary, and arteriovenous malformations inevery part of the body. They ranged in ages from six to 42 and from the firstsession of alcohol treatment to advanced stages.
One of them was a young woman with venous malformations in the left neck thathad diffused to her larynx, causing difficulty in breathing and cosmeticproblems.
She was treated when young through surgery, but the condition persisted andslowly worsened again.
Vascular surgeons refused to treat her surgically again, and so interventionalradiological approach was an appropriate choice.
She had had alcohol injected two times before, and this was the third session.
According to Yakes and Luan, some 1 percent of the global population suffersfrom vascular malformations, including in the central nervous system or itsperiphery. Management is chosen in case of clinical symptoms or cosmeticproblems.
The rate of cure using various treatments is low but Yakes said alcoholictreatment has a higher chance than others.
In Luan’s unit, many cases have been successfully controlled or cured usingthis technique.
But Yakes said vascular malformations should be treated using multiple methods.
Vascular malformations and hemangioma should be distinguished from each other.
So patients need to consult experts and use imaging such as ultrasound,computed tomography or even magnetic resonance imaging for a precise diagnosis.
Once a patient is finally diagnosed, a tailored treatment is chosen by experts.-VNS/VNA
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