Sclerotherapy information sheet

This information sheet explains sclerotherapy treatment, why it might be suggested for your child, and what to expect when your child comes to Sydney Children’s Hospital at Randwick for sclerotherapy treatment.

This information is not meant to replace discussions with your child’s vascular anomalies team and not all of it may apply to your child. Please feel free to ask the team any questions or raise any concerns you may have about your child and their treatment.

Sclerotherapy is a procedure where a medication, or ‘sclerosant,’ is injected into the malformation to obliterate all or part of it. It is used to treat some types of vascular malformations. 

Sclerotherapy is carried out in the Department of Radiology by an interventional radiologist, a doctor who specialises in image guided procedures.

Most of the time, sclerotherapy is an elective procedure. If the V-TAC team believe it is more necessary or urgent they will discuss this with you.

You child will usually have had an ultrasound or MRI. The results are then discussed with the multidisciplinary Vascular Tumours and Anomalies Centre (V-TAC) team. Sclerotherapy is recommended by the team, based on your child’s symptoms and test results. 

We will book your child in for up to three or four treatments 4 to 8 weeks apart. More or less treatments may be required, and we will re-assess this regularly. Our V-TAC nurse will be in touch with you to confirm the treatment dates. The doctors will discuss with you what sclerosant/medication would be best to be used and if any other methods will be used to treat the malformation. 

If the area to be treated is in an area where compression can be applied, we will arrange for the physiotherapist to measure your child for a custom-made compression garment that is to be worn after treatment. These garments can take up to three weeks to arrive so make sure you have this done in time for your child’s first treatment. 

In children with a venous malformation, we will do a blood test to check for any clotting abnormalities, and to make sure the biochemistry is normal. If any abnormality is found, treatment of this may be required before the sclerotherapy to reduce the risk of clotting complications. This will be discussed and arranged when you see the V-TAC team. 

You will receive information about how to prepare your child for the procedure in your admission letter. If required, arrangements will be made for you to come to the hospital a few days or weeks before the procedure for a preadmission check by the anaesthetist. You will also receive a call in the week before to make sure your child is well and to confirm the arrangements for treatment. If your child or their accompanying adult are not well, the treatment will have to be rescheduled.

Your child will return to the ward after they have recovered from the anaesthetic. 

The treated area may become quite swollen. This should subside after a few days and resolve almost completely over two-three weeks. 

If the treatment has been in the neck or another vital area, your child may be monitored in the intensive care unit. In that case, they may need to be on a breathing machine until the swelling settles. This is to prevent any unexpected breathing problems. This will be discussed with you and planned before the treatment. 

If your child has a compression garment, they need to have it on as soon as possible after the treatment. Otherwise, the area may be bandaged or have a dressing on it.

You will be able to take your child home once the doctors/nurses are happy that your child is recovering well. 

Any bruising and swelling of the malformation will only last for a few days. Some parents say that the discomfort or swelling is more noticeable on day 3 or 4 rather than straight after the procedure. This is normal. Children’s pain relief medicine such as paracetamol or ibuprofen is usually enough to deal with any pain. 

Depending on the area treated, your child should be able to go back to childcare/preschool/school within a few days. Any compression garment or bandages should be worn until the next treatment or 4 to 6 weeks following treaments. They can play sport after three weeks if they feel comfortable. 

The doctors/nurses will tell you if your child needs further sclerotherapy procedures and if so, when. 

Your child may be booked for a series of treatments, or it may be a single treatment. After your booked treatments have been completed, we will arrange to review your child at the V-TAC Clinic in 4 to 6 months. This is so the doctors can check on your child’s progress and decide whether the treatment has worked or more treatments may be required

Your child might need several sclerotherapy procedures to reduce the size and effect of malformation. As sclerotherapy causes swelling and discomfort, it is safer to carry out several smaller treatments, limiting these effects each time. 

Sclerotherapy will not ‘cure’ the malformation, but it should shrink it significantly. Children may need to have further sclerotherapy as they get older and, in some, surgery may be suggested to improve the result. 

Your doctor will explain the options for treatment suitable for your child. These recommendations may change as time goes on.