الفهرس 
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Abstract
Venous malformation (VM) is the most common form of
vascular malformation, which affects approximately 1%
of the population. VM affects different anatomic regions of
the body and different types of tissues, with variable
presenting symptoms including swelling/contour deformity,
skin discolouration and pain.
Venous malformations remain a challenging clinical
entity to diagnose and treat. They have been treated by a variety
of modalities, including surgery, various forms of sclerotherapy,
laser therapy and other modalities as radiofrequency ablation
and electrochemical treatment or a combination of these
methods. The choice of treatment should therefore be
individualized based on several factors such as the depth, extent,
and anatomical location of the lesion.
Because many venous malformations are not fully
resectable, sclerotherapy has emerged as the primary treatment
option for venous malformations). Sclerotherapy involves the
injection of a sclerosant into the malformation, which causes
cellular destruction, thrombosis, and intense inflammation and
scarring leads to shrinkage of the lesion.
Sclerotherapy is a generally safe, less invasive, costeffective,
and practical technique for the treatment of VMs,and several studies have documented reduction in the size of
the malformation and improvement in pain.
Interstitial Nd-YAG laser coagulation is another
effective and minimally invasive method for treating venous
malformations and is an alternative or complimentary to other
therapies, the mechanism of this treatment is to reduce bulk and
hypervascularisation and improve contour and function.
Venous malformations, although benign lesions, can
present a diagnostic and management challenge. Although
the different therapeutic options have been described to date
their individual relevance has still to be defined. Due to
absence of clear studies comparing different treatment
modalities especially between interstitial laser and
sclerotherapy, so our comparative study between
sclerotherapy and Nd:YAG interstitial laser in the treatment
of venous malformations is unique study.
Our study was done to compare effectiveness of
bleomycin Sclerotherapy and Nd:YAG interstitial laser in the
treatment of venous malformation by using subjective
clinical assessment and objective changes on MR imaging.
This was the first study with no previous studies conducted
to compare this effectiveness. Study occurred at plastic
surgery department in Ain Shams University hospitals between June 2015 to June 2018. It included 30 patients of
all age groups of both sex, with venous malformation.
Patients were divided into two groups I and II. group I
included15 patients with were treated by bleomycin
sclerotherapy and groups II treated by Nd:YAG interstitial
laser.
Complications in our study in comparison to other
studies were minimal and there was no major complications
occurred in both groups.
In our study, there was significant improvement and
complete response in (73.3%) of patients treated by
bleomycin sclerotherapy
In group I, we found significant improvement in lesion
size in cm^2 (5.76±3.42), moderate improvement in lesion
size (13.46±2.83) and mild improvement in lesion size
(15.49±0.00). Also, we found significant improvement in
infiltrating type of venous malformation (81.8%).
In group II, we found that mild improvement in
(53.3%) of patients and moderate improvement in (46.7%)
In group II, we found moderate improvement in lesion
size (4.31±2.09) and mild improvement in lesion size
(11.31±3.18).also moderate improvement occurred with average (81.95±38.44) Joule/cm2 while mild improvement
occurred with average (50.95±15.91). Also, we found mild
improvement in infiltrating type of venous malformation.