Natural progression and early recurrence of venous malformations following surgical and endovascular treatments: A 15-year retrospective cohort study

Abstract

Background Venous malformations (VMs) are the most common type of vascular malformation. Recurrence after treatment remains a significant challenge in clinical management. Methods A multi-center retrospective cohort study was conducted on consecutive patients who received surgical or endovascular VM treatment from 2005 to 2020. The study aimed to compare treatment efficacy between surgical and non-surgical endovascular approaches. Post-treatment size, symptoms, and recurrence were evaluated more than 1 year after treatment. Results Ninety-eight patients with 288 VM treatment cases were included. The mean follow-up duration was 60.7 ± 42.4 months. Both surgical and non-surgical treatments showed size improvement and symptom improvement in more than 90% and 75% of the cohort, respectively. Regarding recurrence, patients who underwent total resection (26.5%; p < .001) and primary closure (44.6%; p = .04) had significantly lower recurrence rates among the whole cohort. Conclusion Where feasible, total resection is the ideal treatment modality. Sclerotherapy has a higher long-term recurrence rate but is a less invasive procedure that can be performed repeatedly.