Search

Dural venous sinus cysts are very infrequent lesions, generally asymptomatic and incidental. These cystic lesions may include venous structures continuing with superficial cortical veins. A 23-year-old male patient presented with a severe headache. Cranial computed tomography and contrast-enhanced magnetic resonance imaging demonstrated a well-defined, central curvilinear enhanced lesion, located in the superior sagittal sinus which was compatible with the intraluminal dural venous cyst. The patient was included imaging follow-up for possible growth of this cystic lesion. Dural venous sinus cysts are asymptomatic lesions by far. However, these incidental lesions should be followed up just in case the progression-occlusion of the dural sinus. Possible venous components that may have connections with cortical veins should be considered in terms of surgery. [ABSTRACT FROM AUTHOR]

Background Incompetence at the saphenofemoral junction (SF) is the most common cause (70%) of varicose veins. Endovenous laser ablation (EVLA) uses laser energy to ablate incompetent axial veins selectively and was originally described for the treatment of GSV reflux and its related varicosities. The venous system is a network of interconnected vessels; any preserved inflow of the saphenous-femoral mouth can cause postoperative recurrence. However, according to the literature, the greatest risk of recurrence is associated with the stump of the GSV of venous tributaries, including great venous trunks parallel to the GSV in the thigh. Aim of the work Comparison of the standard endovenous laser ablation technique (1.5–2 cm from SFJ) versus crossectomy ablation for the treatment of varicose veins regarding recurrence of reflux and incidence of endovenous heat-induced thrombus (EHIT) in the first week. Patients and methods In all, 80 patients admitted to Ain Shams University Hospitals and Alexandria Armed Forces Hospital from Jan. 1st, 2021 to Jan. 30th, 2023 participated in the study. The patients were divided evenly into two groups: Participants were randomly assigned to one of the trial groups using the sealed envelope method.Group A was treated by ablation of the great saphenous vein at the saphenofemoral junction (0 cm from SFJ) using 1470 nm radial double-ring diode laser fibers (ELVeS Radial 2ring™ fiber) and Biolitec Ceralas E1470/15 W laser machine. Group B was treated by ablation of the great saphenous vein at 1.5–2 cm from the saphenofemoral junction using the same laser fiber and machine. Ablation was done after putting an appropriate amount of tumescent anesthesia (500 mg lidocaine, 1 mg of epinephrine, and 12.5 mEq sodium bicarbonate added to a 1-liter solution of 0.9% normal saline). The ultrasound machine was used for the accurate placement of the laser fiber. Postoperative duplex was done on day 1, 1 week, and at 6, 12, and 18 months. Results Mean age: 39.28+/– 12.27 years in both groups; M/F: 23/17 in the first group, 20/20 in the second group. Postoperative duplex showed the absence of reflux in both groups after 1 day, after 6 months. One patient (2.5%) in group A and four patients (10%) in group B showed recurrent reflux, while recurrent refluxes were observed in one case (2.5%) in group A and five cases (12.5%) in the other group after 12 and 18 months of follow-up. One patient (2.5%) developed superficial thrombophlebitis along the course of the ablated great saphenous vein in both groups while extension to the deep veins was not detected in both groups. Conclusion Crossectomy (ablation at 0 cm at SFJ) ablation of varicose veins with 1470 radial double rings and nm diode laser with an appropriate amount of tumescent showed better results with less recurrence rate due to neovascularization or tributaries left than the standard technique of endovenous laser ablation of varicose veins (1.5–2 CM from SFJ). Along with showing a lesser incidence of thermal propagation into the deep system (EHIT) both crossectomy and standard techniques showed the same complication rate regarding venous thrombosis. [ABSTRACT FROM AUTHOR]

Background Over the years, there have been significant advancements in the treatment of varicose veins. In most surgical settings, the open procedure is still the primary approach. Yet, the popularity of less invasive procedures like EVLA and RFA has produced fantastic outcomes. Objective to assess the safest power of laser which gives maximal effect and least complications in ablation of varicose veins. Methodology A prospective observational study inducing EVLA of different laser power settings (7W & 10W) with preoperative assessment then follow up by CEAP & VCSS and duplex ultrasound measuring great saphenous vein (GSV) diameter and also postoperative complications and time to return to work. Results This study included 50 patients (52 limbs). The Patients were distributed as regard laser power used into two groups (7W, 10W) of 26 limbs for each one. As regard GSV measures changes, there was highly statistically significant decrease in GSV diameter after 1m and after 3m compared to preoperative, with P value P<0.001, among patients group. Also, there is higher number of cases with GSV>10mm in power of laser '10w' group compared to '7w; group, with P value (P<0.001); while there is no statistically significant difference between power of laser 7w versus 10w, because all patients ≤10mm after 1 month and after 3 months, with P value >0.05. Statistically there was no significant difference between 7W & 10W groups as regards time to return to work, CEAP scores and postoperative complications except the significant difference in Pain over the treated vein being less in 7W laser power group. Conclusion For endovenous laser ablation of varicose veins, both 7W and 10W laser power are indicated. They are risk-free and provide the greatest impact with the fewest difficulties for the chosen vein diameter. In our investigation, we came to the conclusion that patients with small GSV diameter required low laser power (7W), while those with large GSV diameter required high laser power (10W). [ABSTRACT FROM AUTHOR]

Background Venous leg ulcers are a considerable health problem because of their high incidence, slow healing, high recurrence rate, and high cost of treatment. Minimally invasive treatments such as endovenous thermal ablation and foam sclerotherapy proved to be safe and effective. However, there is a paucity in studies focusing on the management of postphlebitic venous ulcers using endovenous thermal ablation of the superficial system in combination with foam sclerotherapy. Objectives The aim of our study was to assess the healing time, procedure-related complications and recurrence rate in patients having a postphlebitic venous leg ulcer after being treated with EVLA associated with ultrasound-guided foam sclerotherapy to incompetent perforators with compression therapy. Subjects and methods This is a prospective observational study, conducted at Ain Shams University Hospitals and Nasser institute hospital in Cairo on 30 patients presented with postphlebitic venous leg ulcers. Results After one year, 90% of cases had a totally healed ulcers, 10% with ulcer decrease in size of more than 50%, and recurrence rate 6.7%. The adverse events of this procedure were DVT (6%), hematoma (6%), ecchymosis (43%), thrombophlebitis (6%), and pain (70%). There was significant improvement of the VCSS as regard pain, edema, inflammation, ulcer size, and number. There was highly significant (P < 0.0001) improvement in the mean (SD) VCSS (preoperative 18 [2.808] vs. postoperative 6.367 [2.3449]). Conclusion Patients with totally recanalized deep venous system post deep venous thrombosis, presenting with nonhealing venous leg ulcers, may benefit from thermal ablation of superficial varicose veins combined with ultrasound-guided foam sclerotherapy. This combined approach is a feasible, safe, and effective modality in terms of improved healing rate, low recurrence rate, low complications, and significant improvement in quality of life. [ABSTRACT FROM AUTHOR]

Purpose to provide a road map for converting varicose veins service to endovenous ablation and assess its process and outcome on patients with varicose veins. Patients and methods Retrospective assessment of prospectively recorded data for converting vein unit which exclusively did open varicose veins surgery (OS) (39 patients from September 2019 to February 2020) to endovenous radiofrequency ablation (ERFA) service (44 patients from March 2020 to January 2021). Results There was no statistical difference in theatre time between both interventions despite dealing with more complex cases in the ERFA group with more truncal veins (χ²=11.950*, P<0.001*) and a higher number of stab avulsions (V number) (χ²=217.889, P<0.001*). On the other hand, the overall cost was significantly lower in open group compared to ERFA (Mean±SD 1261±386 US$ and 1519.2±392 US$ respectively, P<0.001*. This statistical difference was reduced to P=0.041 when subgroup analysis only included cases with higher number of avulsions. In multivariate analysis, cost was associated with surgical duration and using ERFA however, less complications were recorded in ERFA group (χ2=4.419* P=0.036*) and recovery time was significantly longer in open group (8.90±2.44) than in ERFA group (6.0±1.06), P<0.001* Conclusion Converting varicose veins service to a modern ERFA is safe and effective when properly planned. ERFA is associated with shorter recovery and less theatre time and complications despite higher cost which becomes more cost-effective in cases with more truncal veins and avulsion sites. [ABSTRACT FROM AUTHOR]

Objectives This was an open-label randomized comparative two arms study to assess the efficacy and clinical outcome of endovenous thermal ablation on reticular veins and telangiectasias in patients with lower limbs varicose veins with incompetent Sapheno-femoral Junction. Patients and methods A total of 40 patients [15 (37.5%) males and 25 (62.5%) females] with reflux of the long saphenous vein were subjected to radiofrequency ablation (RFA). 20 patients had RFA alone while the other 20 patients underwent RFA and injection sclerotherapy. Then patients were followed up on 1 week after the procedure, 3 months, 6 months, and 1 year by duplex and clinically using venous clinical severity score. Results There were 37.5% males and 62.5% females. There was a statistically significant difference in both groups regarding patients' symptoms (pain, heaviness, and swelling) before and after serial times of follow-up, which was assessed by the VCSS, denoting marked improvement of patients' symptoms. Also, there was a statistically significant difference (P<0.001) concerning duplex results regards the reflux before and following RFA. Reticular veins follow-up, we found that in group A they were present among 35% of patients on 1-week follow-up. This increased to reach 70% after 1 year of follow-up, however, in group B they were absent among all patients on 1 week follow-up. They were present among 15% of patients after 1 year of follow-up. Conclusion RFA with concomitant sclerotherapy for the associated minor veins have proved to be safe, cost-effective and more patient satisfaction than RFA without concomitant sclerotherapy. [ABSTRACT FROM AUTHOR]

We report anesthesia management of sclerotherapy for vascular malformations (VMs) of the upper airway and face of pediatric patients conducted under sedation using a high-flow nasal cannula (HFNC) oxygen delivery system. Sclerotherapy procedures were carried out in six patients (five males, one female; age group: 5-12 years). The patients were sedated with midazolam, fentanyl, ketamine, and graded doses of propofol along with continuous oxygen delivery using HFNC. There were no episodes of oxygen desaturation, tongue fall or obstruction of the airway, interruption of procedure for assisted ventilation, and postoperative nausea and vomiting (PONV). Only two patients showed transient apnea for 10 and 15 s but did not require ventilatory assistance. HFNC provides effective oxygenation in pediatric patients undergoing sclerotherapy of VMs of the upper airway and face under sedation. [ABSTRACT FROM AUTHOR]

Background Endovenous laser ablation (EVLA) is of no standardized settings, particularly the laser power that remains under question. Objective To assess the safest power of laser with maximal effect and least complications in ablation of varicose veins. Patients and methods A prospective observational randomized study inducing EVLA of different laser power settings (7 and 10 W) with preoperative assessment, then follow-up by CEAP [classification stands for Clinical (C), Etiological (E), Anatomical (A), and Pathophysiological (P)] and venous clinical severity score (VCSS), and duplex ultrasound as well as postoperative complications. Results This study included 50 patients (52 limbs). Preoperative complaint was mainly in the form of pain on standing and prominent varicosities. The patients were distributed as regards laser power used into two groups (7, 10 W) of 26 limbs for each one. There was a significant difference (P<0.05) between both groups of patients as regards VCSS after 3 months being better in the 10W group. As regards great saphenous vein measure changes, there was a high significant difference (P<0.001) between those exposed to laser power 7W in comparison with those of 10W at 1- and 3 months follow-up in relation to preoperative measures showing more reduction in the 7W group. Statistically, there was no significant difference between 7 and 10W groups as regards time to return to work, CEAP [classification stands for Clinical (C), Etiological (E), Anatomical (A), and Pathophysiological (P)] scores, and postoperative complications, except significant differences in pain over the treated vein being less in the 7-W laser power group. Conclusion About 10-W laser power of EVLA was associated with better postoperative VCSSs, despite different power settings were not affecting time of return to work and other postoperative complications apart from less pain over treated veins with 7-W laser power. We call for further studies of large size and long follow-up due to few available related studies. [ABSTRACT FROM AUTHOR]

Background: Rectal prolapse in children is mainly managed by conservative treatment, especially in those aged <3 years; however, intervention is indicated in cases with persistent and recurrent prolapse that is resistant to conservative treatment. Objective: To determine the efficacy of sclerotherapy using sodium tetradecyl sulphate as a sclerosant in treating rectal prolapse in children. Design: A retrospective chart review. Settings: The study was conducted in a tertiary care pediatric center in Bengaluru, Karnataka. Patients (Material) and Methods: Children aged =1 year with persistent rectal prolapse were included in this study, which was conducted from January 2013 to December 2021. The median follow-up period was 1 year. Main Outcome Measure: Resolution of the rectal prolapse. Sample Size: Three hundred and eighty-seven patients. Results: The success rate was 93.5% (43/46) after sclerotherapy treatment. Recurrence was noted in 6.5% of the patients who required a second dose of sclerotherapy or surgery. The median follow-up period was 8 months. There were no remarkable complications or mortality. Conclusion: Rectal sclerotherapy injection is a safe, low-cost procedure with low recurrence rate in children. Limitations: Ours was a retrospective, single-center study, and no control group was utilized. Conflict of Interest: The authors have no conflict of interest to declare. [ABSTRACT FROM AUTHOR]

Objectives Saphenous stripping and high ligation is the traditional operation for varicose veins globally. Postoperative complications like pain, subcutaneous ecchymosis, hematoma, and wound dehiscence are possible. The study assesses the role of ultrasound-guided tumescent fluid infiltration through saphenous fascia to reduce these complications. Patients and methods A single-arm prospective cohort study was conducted on 300 cases between February 2020 and February 2022 at Ain Shams University Hospital and Shebin El-Kom Teaching Hospital. Results A total of 300 patients who received saphenous stripping and high ligation operation were associated with ultrasound-guided infiltration of tumescent solution through saphenous fascial. Pain was assessed by visual analog scale score between first day and 1 week, which showed significant improvement. Ecchymosis was assessed based on the ecchymosis score between 1 and 4 weeks, with significant improvement. Subcutaneous hematoma and wound complications were also observed at 1 and 4 weeks, without significant improvement. Conclusions Ultrasound-guided tumescent solution infiltration along saphenous fascia possibly improves postoperative pain score and ecchymosis but not hematoma and wound complications. [ABSTRACT FROM AUTHOR]

Background Pelvic congestion syndrome is defined as intermittent or constant pain that persists for at least 3–6 months, is localized in the abdomen or pelvis, is not associated with pregnancy, is not limited to any period of menstrual cycle or intercourse, and is severe enough to cause functional disability or require treatment. This condition has been recognized as a potential cause of chronic pelvic pain (CPP) in women of childbearing age. The aim of this study was to detect the efficacy of embolization of ovarian veins by assessing the adequacy of closure of incompetent pelvic veins and abolishment of venous reflux in the addressed ovarian veins. Patients and methods A single-center prospective study was conducted on 14 women of childbearing age complaining of CPP associated with dysmenorrhea, dyspareunia, and\or vulvar varicosity, lower limb pain. All patients underwent lower limb venous duplex as well as pelvis duplex to assess the presence of dilated and refluxing ovarian vein more than 6 mm in diameter. Gynecological causes of pelvic pain were excluded; all patients underwent venography in an angiosuite to confirm the diagnosis of dilated ovarian vein and presence of parametrial varicosities. Embolization of ovarian vein and associated pelvic veins was done using foam sclerotherapy with polidocanol and coiling of the ovarian vein with coils ranging from 8 to 12 mm in diameter. Results In our study, there was a statistically significant improvement in symptoms in our patients after coiling during the follow-up compared with before coiling, including CPP (P=0.002), lower limb pain (P=0.003), dyspareunia (P=0.003), and dysmenorrhea (P=0.002). Conclusion The embolization of ovarian vein is feasible, safe, and effective with high rates of success and clinical improvement in the treatment of pelvic congestion syndrome. [ABSTRACT FROM AUTHOR]

Vascular malformations can be treated using sclerotherapy agents like alcohol, polidocanol, or sodium tetradecyl sulfate foam and embolization treatments. These endovascular treatments may cause severe complications as pulmonary embolism and thrombosis. 980-nm diode lasers (DLs) are common devices used by many specialties as plastic surgeons, dermatologists, and vascular surgeons. Laser energy is excellently absorbed in water and hemoglobin, which makes it ideal for adipose tissue and deep lesions. We treated our patient using a DL. Our surgical approach allowed total excision of the arteriovenous malformation (AVM), which decreased the size of the tumor allowing a smaller incision and eased the dissection plane. We believe that lasers will be used more frequently on AVM treatments. [ABSTRACT FROM AUTHOR]

Mucocele is a mucous-filled cavity that can occur at various locations in the body including the oral cavity. There are various treatment options for mucoceles ranging from surgery, laser surgery, cryosurgery, etc. Due to the invasive surgical procedures and high chances of recurrence even after surgery, the focus of interest has now shifted to nonsurgical ways of management which show negligible side effects including the use of corticosteroids and sclerotherapy using various drugs. Further, no need for local anesthesia is an added advantage of the sclerotherapy procedure. [ABSTRACT FROM AUTHOR]

Introduction: Pyogenic granuloma is a commonly occurring inflammatory hyperplasia involving skin and mucous membranes. Various modalities of treatment have been used to treat pyogenic granuloma. However, there is an increased risk of intraoperative bleeding and recurrence of pyogenic granuloma following surgical treatment of pyogenic granuloma. Therefore, sclerotherapy has evolved as an effective alternative treatment modality in excellent safety and efficacy. Aims and Objectives: The aim of this study was to assess the safety and efficacy of 3% polidocanol in liquid form in pyogenic granuloma as a sclerosant. Settings and Design: This was a retrospective study of cases treated between March 2019 and February 2020 at two different private institutes. Materials and Methods: The study included 30 patients with 30 pyogenic granulomas treated with 3% polidocanol liquid. Individuals with comorbid conditions such as diabetes, hypertension, thyroid disorders, and those who were on medications were excluded from the study. Two units of 3% polidocanol solution were injected with an insulin syringe at the base of the lesion. Changes in lesions and adverse events were recorded and injections were repeated after a gap of 2 weeks if needed. Result: In 28 patients, there was complete resolution of the lesion within 4 weeks and 2 patients received a second injection of polidocanol. All the patients tolerated the procedure and the lesions resolved without any significant sequelae. Discussion: The advantages of 3% polidocanol sclerotherapy are that it is a safe, easy, effective, and minimally invasive procedure with little discomfort to the patient and very minimal complications as compared with other modalities. Conclusion: Polidocanol 3% solution is an effective sclerosant for the treatment of pyogenic granuloma. The aim of this study was to assess the safety and efficacy of 3% polidocanol in the liquid form in PG as a sclerosant. [ABSTRACT FROM AUTHOR]

Background Pelvic venous disorders (PeVD) are a network of disease syndromes that cause chronic pelvic pain and/or lower extremity symptoms in women. Aim The aim of this study was to compare the endovascular and laparoscopic interventions for symptomatic ovarian veins reflux assessing the technical feasibility, complications, and early clinical and radiographic outcomes from 6 weeks to 6 months. Patients and methods This study was conducted on 40 women complaining of chronic pelvic pain. The patients were classified into two groups: the first group (20 patients) was laparoscopically treated by resection of part of the ovarian (gonadal) vein near the site of connection with left renal vein or inferior vena cava (according to the side of vein refluxing), and the other group was treated by endovascular coiling and sclerotherapy of the refluxing gonadal vein. They were followed up from 6 weeks to 6 months. The endovascular procedure was carried out under local anesthesia via the transfemoral vein approach with routine supine position and then the left ovarian vein was cannulated using a 5-Fr catheter. Then, renal venography with Valsalva technique was done to detect reflux of the left ovarian vein. Embolization was typically performed using a 'sandwich' technique, which combines metallic devices (coils) with 2 or 3% atheoxysclerol foam. Although the laparoscopic operation was carried out under general anesthesia with right lateral position for handling of the left gonadal vein and left lateral position for handling of the right gonadal vein. Endoscopic titanium clips were used for occlusion of proximal end of the gonadal vein without traction to prevent detachment from the renal vein followed by part of vein excision. Results In the endovascular group, there was marked improvement concerning all of the preprocedural symptoms of PeVD s with obvious significant statistical difference. In the laparoscopic group, not all PeVD s showed significant postoperative improvement. Patients with menorrhagia, vulvar varicosities and urinary, or anal symptoms showed no significant statistical difference, with P value more than 0.05. Conclusion Endovascular and laparoscopic interventions are effective and safe in eliminating pathologic blood reflux along the gonadal veins; however, the laparoscopic intervention cannot improve the urinary symptoms or vulvar varicosities. Moreover, laparoscopy may be beneficial in exclusion of any gynecological pathology, but the endovascular procedure is more effective in all pelvic congestion symptoms, with satisfactory improvement, shorter duration, and less complications. [ABSTRACT FROM AUTHOR]

Background Over the last 10–15 years, percutaneous endovenous ablation has largely replaced ligation and stripping of the great saphenous vein, which has been associated with high success and low complication rates. Objective The goal of this study was to compare the effectiveness of endovenous radiofrequency ablation (RFA) of primary varicose veins with conventional surgery in terms of pain, complications, recurrence, quality of life, and return to normal activities using standard parameters. Patients and methods Both methods were used on a total of 63 limbs (54 individuals) with great saphenous vein reflux and lower-limb varicose veins. Clinical and duplex ultrasound examinations, as well as quality-of-life assessments, were performed as part of the follow-up. Results There were no significant differences between both groups as regards the demographic data. The pain score shows a significant difference between both groups (P<0.0001) in favor of the RFA group. Mean venous clinical severity scores improved from 5.73 ± 3.194 to 3.45 ± 2.279 at 1 month and 2.36 ± 1.851 at 6 months in the conventional surgery group and from 5.97 ± 3.538 to 3.10 ± 2.657 at 1 month and 1.80 ± 1.448 at 6 months in the RFA group. Complications represent 30.30% of patients in the surgical group compared with 16.67% of patients in the ablation group (P=0.5668). There was a statistically significant difference as regards returning to normal activity (7.21 ± 1.634 days for the surgical group vs. 3.00 ± 1.323 days for the ablation group). Conclusion The occlusion incidence and clinical recurrence of individuals who received radiofrequency thermoablation were equal to those who underwent saphenous vein stripping. Patients who received radiofrequency thermoablation, on the other hand, had a better quality of life, experienced less postoperative discomfort, had a lower complication rate, and missed work for a shorter period of time in comparison with those who underwent the traditional technique. [ABSTRACT FROM AUTHOR]

Context: As propranolol has emerged as first-line therapy for problematic infantile hemangioma, the number of non-responders and partial responders to propranolol therapy is also increasing. Aims: The study was conducted to evaluate the response of intralesional bleomycin, triamcinolone, and a combination of both as second line of treatment for the residual hemangioma following propranolol therapy Settings and Design: A prospective comparative study was conducted in patients who were either non-responders or partial responders to previous propranolol treatment. Materials and Methods: The patients randomly received injection bleomycin, injection triamcinolone, and combination of both bleomycin and triamcinolone. The response to treatment was recorded clinically by using photographs. The pathological response was assessed by calculating pre-treatment and post-treatment microvessel density in biopsy of lesion from the non-cosmetic sites using immunohistochemistry. Statistical Analysis Used: 2 test was used to test the association between the variables. The utility of microvessel diameter (MVD) in terms of clinical response to the therapy was predicted by using receiver operating characteristic (ROC) curve. Results: Out of the 134 patients, 42 received bleomycin and 44 received triamcinolone and were treated with a combination of both. The overall clinical response was better in the combination group compared with the bleomycin group (P = 0.018) and triamcinolone group (P = 0.0005), respectively, after 6 months of follow-up. There was no difference in clinical response between the triamcinolone and bleomycin groups. Change in MVD correlated with the clinical response. Conclusion: The combination of bleomycin and triamcinolone is effective and safe for the treatment of residual hemangioma. [ABSTRACT FROM AUTHOR]

Dear Editor, Ethanol sclerotherapy is an effective way of managing arteriovenous malformation (AVM) cases. A 27-year-old male patient, the American Society of Anesthesiologists (ASA) physical status class I, was posted for ethanol sclerotherapy of left upper extremity vessels for AVM. [Extracted from the article]

Aim: The aim of the study was to evaluate the results of injection sclerotherapy with bleomycin in pediatric patients with lymphatic malformations. Materials and Methods: In this prospective cohort study, all consenting pediatric patients with macrocystic lymphatic malformations were managed with injection bleomycin sclerotherapy (0.5 mg/kg, not exceeding 5 mg at a time) under ultrasound (US) guidance. After aspirating the cyst fluid bleomycin was instilled intralesionally in a ratio of 5:1 (aspirated cyst fluid volume: diluted bleomycin solution volume). Patients were reassessed at three weekly intervals. The response to therapy was assessed clinically as well as by size and volume on ultrasound Doppler study. The response was classified as excellent response, i.e., complete regression, good response >50% regression, and poor response <50% regression. Results: Sixty patients with lymphatic malformations were enrolled in the study, the mean age was 3.22 years, and the male-to-female was 2.5:1. The most common site of lesion was in the neck (43.3%), followed by the axilla (15%) and flank (8.3%). The responses were excellent, good, and poor in 43 (71.6%), 12 (20%), and five (8.3%) patients, respectively. Two patients underwent surgical excision of the residual lesion. Complications noted were fever in six, local pain in five, and residual lesion in three patients. Conclusion: Sclerotherapy with bleomycin is simple, safe, and effective in the first line of management for macrocystic lymphatic malformations in children. [ABSTRACT FROM AUTHOR]

The article describes the case of a 65-year-old female with bleeding superficial lower limb varicosities and was referred to a vascular unit for definitive treatment. Topics discussed include finding on clinical examination, the patient's diagnosis of varicosities secondary to severe tricuspid regurgitation (TR), and effectiveness of sclerotherapy to chemically ablate a relatively short segment of the vein to manage the local symptoms/complications.

The article presents a case of a 19-year-old male who was rushed to a hospital due to multiple painless bluish-red skin lesions on the dorsum of his right foot since early childhood and profuse bleeding following local trauma to discuss Stewart-Bluefarb syndrome (SBS). Also cited are the differential diagnosis of his condition like Parkes Weber syndrome (PWS), Klippel-Trenaunay syndrome (KTS), and verrucous hemangioma.

A case study of 16‑year‑old male is presented with an asymptomatic bluish‑cultured papule over the shaft of the penis for several months. Topics include examines there was no history of bleeding from the lesion and there was no previous history of trauma, infection, surgery and fever as his sexual history and family history were non‑significant.

Background: Dermoid cyst, a developmental benign choristoma, is the most common orbital tumor of childhood, arising from ectodermal sequestration along the lines of embryonic fusion of mesodermal processes, lined by keratinized stratified squamous epithelium and expanding slowly due to constant desquamation and dermal glandular elements. Approximately 80% are found in the head and neck region and comprise 3-9% all orbital masses.Purpose: It is mandatory to know about the variable presentations of orbital dermoids and the surgical techniques that can be adopted based on the site, extent, age and aesthetic needs, presence of inflammation and possibility of intraoperative rupture.Synopsis: Orbital dermoids can be classified as juxta-sutural, sutural or soft tissue cysts; superficial or deep; intraosseous or extraosseous, and intraorbital or extraorbital. These smooth, painless, mobile or partially mobile lesions mostly present at the fronto-zygomatic suture with proptosis, displacement, ptosis or diplopia, depending on depth and extent. Therefore, it is important to understand the various presentations and the appropriate surgical techniques.Highlights: We describe the embryological origin, types and clinical features of dermoids in this video and demonstrate the surgical and minimally invasive techniques for their management.Video Link: https://youtu.be/-q3xD2igjcQ. [ABSTRACT FROM AUTHOR]