Tuleja, Aleksandra Beata; Bernhard, Sarah M.; Döring, Yvonne; Helfenstein, Fabrice; Rössler, Jochen; Boon, Laurence M.; Vikkula, Miikka; Haupt, Fabian; Hamvas, Györgyi; Baumgartner, Iris (May 2024). The Impact of Alcohol Embolization on Pain Relief in Patients with Peripheral Venous Malformations: a comparative study. (Unpublished). In: ISSVA World COngress 2024: The Latest in Vascular Anomalies. Madrid, Spain. 7-10 May, 2024.
PURPOSE: Various treatment modalities have been applied for symptomatic venous malformations, with alcohol embolization being a common approach. However, the benefits and complications of this therapy require rigorous evaluation in the face of emerging new, targeted treatments. The aim of this study was to evaluate the efficacy of alcohol embolization in pain management compared with conservative treatment, and to explore associated complications.
METHODS: A retrospective cohort analysis was performed at the Vascular Malformation Center, University Hospital Bern, from 2008 to 2022. Patients with peripheral simple venous malformations were included, one group underwent alcohol embolization and the other group received conservative treatment. Pain levels were measured using the Numeric Pain Scale (NRS). Inverse Probability of Treatment Weights (IPTW) were used to adjust for confounders such as severity of malformation indicated by number of tissues affected, localization, presence of hypertrophic tissue, history of thrombophlebitis, age, pain level at the initial visit. Primary and secondary outcomes included changes in maximum, average, and minimum pain levels.
RESULTS: Of 236 eligible patients, 93 underwent alcohol embolization and 143 received conservative treatment. Both groups showed a reduction in pain over time, with alcohol embolization resulting in a more pronounced reduction in average and minimal pain levels. However, there was no statistical evidence of an advantage of alcohol embolization in reducing maximum pain. Complications occurred in 14% of treated patients, but were generally manageable and did not lead to serious outcomes.
CONCLUSION: Alcohol embolization demonstrated a faster and more significant reduction in mean and minimum pain levels, but its efficacy in relieving maximum pain compared with conservative treatment remains inconclusive. The study highlights the need for a broader perspective on treatment outcomes beyond pain reduction. Future research should focus on holistic measures to improve the overall quality of life of patients with venous malformations and explore alternative therapies.
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