Hoang, a 24-year-old man, sought medical attention for persistent pain, swelling, and muscle atrophy in his left thigh. Diagnostic imaging revealed a large venous malformation, approximately 28 cm long, deeply embedded within the muscles of his left buttock and thigh. This condition led to partial muscle atrophy and prolonged discomfort.

Dr. Thi Van Gung, Head of the Endovascular Intervention Unit at the Imaging Diagnosis and Interventional Radiology Center, Tam Anh General Hospital, Ho Chi Minh City, explained that in a healthy individual, blood flows from arteries, through capillaries, and then returns to veins. However, with a vascular malformation, blood flows directly from an artery to a vein or through abnormal vascular plexuses, resulting in faster flow and higher pressure than normal. Thigh vascular malformations often involve the femoral artery and vein.

Patients with this condition may experience swelling, persistent pain, a feeling of heaviness in the leg, localized heat, or visibly prominent abnormal blood vessels. If detected and treated late, these malformations can lead to chronic pain, limb edema, bleeding, skin ulcers, and impaired motor function.

Hoang underwent an endovascular intervention to eliminate the vascular malformation. This minimally invasive method allows doctors to directly access the malformation from within the vessel, reducing the risk of bleeding and preserving the surrounding muscle structure. Using a digital subtraction angiography (DSA) system, the medical team could precisely visualize the abnormal vascular map, identifying the feeder branches supplying the malformation and the drainage branches leading to the superficial venous system.

Dr. Gung opted for 99.5% refined alcohol as a sclerosant, injecting it directly into the malformed vein. High-concentration alcohol damages the vascular endothelium, causing the malformed vessel to shrink, fibrose, and gradually disappear. Compared to other embolization materials, such as medical glue, alcohol offers the advantage of penetrating deeply into complex malformations.

Dr. Gung (right) and his team treating Hoang's vascular malformation. Photo: Tam Anh General Hospital

The intervention was successful. In the days following the procedure, Hoang's lower limb pulses were closely monitored. He received conventional painkillers and was discharged after one day.

Dr. Gung advised Hoang to attend regular follow-up appointments to monitor the treatment's effectiveness. Vascular malformations can exist silently for many years, only becoming apparent when they cause pain, muscle atrophy, or other complications. Early examination and accurate diagnosis using modern imaging tools like CT, MRI, or DSA are crucial for selecting appropriate treatment methods and potentially avoiding surgery.

Nhat Thanh

*Patient's name has been changed