Tratamento combinado com laser Nd:YAG e escleroterapia com espuma de polidocanol em malformação venosa da mão: relato de caso
Combined treatment with Nd:YAG laser and polidocanol foam sclerotherapy in venous malformation of the hand: case report
Helena de Oliveira Santos; Genaro Fahrnholz Buonsante; Marina Araujo Zulchner; Marcos Arêas Marques
Resumo
Palavras-chave
Abstract
Venous malformations of the hand represent a clinical and therapeutic challenge due to anatomical complexity and functional and aesthetic impact. We report the case of a 13-year-old female patient with a venous malformation of the hand, treated with a combined approach using Nd:YAG 1064 nm transdermal laser and 1% polidocanol foam sclerotherapy. The combination of photocoagulation and sclerotherapy proved safe and effective in a superficial and localized lesion. This case underscores the relevance of combined therapy as a minimally invasive alternative for venous malformations of the hand, highlighting the importance of individualized treatment according to lesion location, depth, and extent.
Keywords
Referências
1 Horbach SER, Rigter IM, Smitt JHS, Reekers JA, Spuls PI, van der Horst CMAM. Intralesional bleomycin injections for vascular malformations: a systematic review and meta-analysis. Plast Reconstr Surg. 2016;137(1):244-56.
2 Hazboun RG, Patnaik R, Karamanos E, Wang HT. Palmar venous malformation: a case report of a rare occurrence and a treatment algorithm. Plast Reconstr Surg Glob Open. 2022;10(4):e4270.
3 Schmidt VF, Masthoff M, Goldann C, et al. Percutaneous sclerotherapy of venous malformations of the hand: a multicenter analysis. Cardiovasc Intervent Radiol. 2021;44(10):1543-50.
4 Ek ET, Suh N, Carlson MG. Vascular anomalies of the hand and wrist. J Am Acad Orthop Surg. 2014;22(6):352-60.
5 Al-Qattan MM. A review of multiple venous malformations of the upper limb: classification, genetics, and pathogenesis. Plast Reconstr Surg Glob Open. 2021;9(1):e3391.
6 Manoli T, Micheel M, Ernemann U, Schaller HE, Stahl S. Treatment algorithm and clinical outcome of venous malformations of the limbs. Dermatol Surg. 2015;41(10):1164-70.
7 Langbroek GB, Horbach SE, van der Vleuten CJ, Ubbink DT, van der Horst CM. Compression therapy for congenital low-flow vascular malformations of the extremities: a systematic review. Phlebology. 2018;33(1):5-13.
8 Scharitzer C, Wolf F, Wiener C, et al. Surgical resection of vascular anomalies of the upper extremity-an observational study. J Clin Med. 2025;14(6):1930.
9 Holly BP, Patel YA, Park J, et al. Preoperative epoxy embolization facilitates the safe and effective resection of venous malformations in the hand and forearm. Hand. 2017;12(4):335-41.
10 Uller W, El-Sobky S, Alomari AI, et al. Preoperative embolization of venous malformations using n-butyl cyanoacrylate. Vasc Endovascular Surg. 2018;52(4):269-74.
11 Guevara CJ, Gonzalez-Araiza G, Kim SK, Sheybani E, Darcy MD. Sclerotherapy of diffuse and infiltrative venous malformations of the hand and distal forearm. Cardiovasc Intervent Radiol. 2016;39(5):705-10.
12 Moreno-Moraga J, Pascu ML, Alcolea JM, et al. Effects of 1064-nm Nd:YAG long-pulse laser on polidocanol microfoam injected for varicose vein treatment: a controlled observational study of 404 legs, after 5-year-long treatment. Lasers Med Sci. 2019;34(7):1325-32.
13 Fresa M, Mazzolai L. Venous malformation of the penis treated with a combined Nd:YAG laser and sclerotherapy technique. Skin Health Dis. 2022;2(3):e114.
14 Gocal W, Hilal E, Tragon T. Nd:YAG laser treatment of massive tongue venous malformation: a case report. Ear Nose Throat J. 2024;103(12):758-61.
15 Zhou P, Chen Y, Chen Z. Limb necrosis caused by sclerotherapy when treating venous malformation. EJVES Short Rep. 2016;32:12-3.
Submetido em:
29/10/2025
Aceito em:
10/05/2026


