Endovascular ethanol ablative therapy is performed under general anesthesia. A diagnostic angiogram is performed at the time of the first procedure and may be repeated with serial treatments depending on the type of vascular malformation present. Our high-volume center takes a multi-disciplinary approach to include the expertise of several specialties including anesthesia, pediatrics, pain specialists, internal medicine, hematology, plastic surgery, vascular surgery, orthopedics and wound care. Most patients are discharged home the same day. Discharge medications usually include a short course of pain medications and steroid tablets to aid in the resolution of swelling and inflammation from the procedure.
What can I expect from my procedure?
Following the procedure, patients usually exhibit focal swelling in the area of malformation treated. Most patients will resolve the majority of the swelling by 2 weeks. In those patients with lower extremity and foot malformations, swelling may last longer because the leg and foot are not only dependent but weight bearing structures as well. In treating vascular malformations of the extremity, deep-vein thrombosis (DVT) is a potential complication. If the malformation has transdermal involvement (involving the layers of the skin) it is not uncommon for skin injury to occur with ultimate healing by scar formation. In the event of skin breakdown, there is risk of infection which may be treated with antibiotics. Peripheral nerve damage is another possible complication due to swelling in the treated compartments. This is usually temporary and improves once swelling has subsided. However, in very rare cases (less than 1%) it can be permanent. Complications from ethanol embolization are generally minimal and this procedure is tolerated well.
What are the risks?