Sclerotherapy information sheet

It is important for anyone having an anaesthetic to have an empty stomach. If the stomach is full, there is a chance that during the anaesthetic whatever is in there could end up somewhere else like the lungs. 

Before the day of the operation, the day surgery staff will call and give you times to stop eating and drinking. Generally, this will mean: 

• No solid food or milk (including formula) for six hours before anaesthesia.
• For breastfeeding children, we usually request 4 hours with no breast-feeds before anaesthesia. Formula feeds are thicker, so they are considered as “solids” for fasting. •
• Clear fluids (things you can see through) up to 1 hour before anaesthesia.

On the day of the procedure, the V-TAC nurse will come and see you. 

You will meet the interventional radiologist, who will explain the procedure in more detail, discuss any questions you may have and ask you to sign a consent form giving permission for your child to have the sclerotherapy. 

If your child has any medical problems, please tell the doctors. An anaesthetist will visit to talk to you about your child’s anaesthetic, and make sure they are fit and well on the day.

Sclerotherapy is usually a day stay procedure. Your child will come into hospital on the day and be discharged once awake and comfortable after the procedure. 

The exceptions are treatment of some larger vascular malformations or those in the head and neck region. These children need to stay the night and may need to be observed in intensive care unit.

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.

Some children feel sick and vomit after a general anaesthetic. Your child may have a headache or sore throat or feel dizzy, but these side effects are usually short-lived and not severe. Your child can start eating and drinking as normal once they feel like 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 treatments. 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.

After going home, you should seek medical attention if:

• Your child is in a lot of pain and pain relief medicine does not seem to help
• The treated area is unusually hot, red and painful or your child is generally unwell with a high temperature or not eating or drinking as usual
• A clot or swelling develops in another part of the malformation
• You have any other concerns that things are not progressing as expected

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. 

Important things to remember:

• Treatment with sclerotherapy aims to reduce the size and symptoms of your child’s vascular malformation.
• The method of sclerotherapy is tailored for each child, and this will be discussed with you before going ahead.
• Most sclerotherapy can be done as a day stay procedure, although some children need to stay in hospital for a day or two while the swelling goes down.
• Sclerotherapy is not a cure, but we hope it will help your child by shrinking the malformation and helping to improve any symptoms they may have. 

If you have any questions about your child’s treatment, please feel free to ask the V-TAC Team at any time.