Percutaneous Sclerotherapy

Introduction:

Percutaneous sclerotherapy is an established and effective treatment option for aneurysmal bone cysts (ABCs). This minimally invasive procedure involves the injection of sclerosing agents into the cystic cavity, leading to sclerosis and subsequent healing.
In this article, we will explore the procedure, benefits, success rate, and the latest advancements in percutaneous sclerotherapy for aneurysmal bone cysts.

What is Percutaneous Sclerotherapy?

Percutaneous sclerotherapy is a minimally invasive procedure performed under image guidance. It involves the injection of sclerosing agents into the cystic cavity, causing irritation and subsequent fibrosis. This promotes the collapse of the cyst and the formation of new bone, leading to healing.

Procedure and Steps: Percutaneous sclerotherapy is typically performed on an outpatient basis and involves the following steps:

Imaging Guidance and Cyst Identification: The cystic lesion is identified using imaging techniques such as ultrasound, CT scan, or MRI. This helps in accurate localization and planning of the procedure.
Access to the Cystic Cavity: Under local or general anesthesia, a needle or catheter is inserted percutaneously into the cystic cavity. This can be done with the guidance of imaging techniques to ensure precise placement.
Fluid Aspiration and Sclerosis: The cystic fluid is aspirated to reduce the intracystic pressure. Sclerosing agents such as ethanol, polidocanol, or doxycycline are then injected into the cystic cavity. The sclerosing agent induces a strong local inflammatory reaction, leading to fibrosis and subsequent cyst collapse.
Post-Sclerotherapy Care: After the procedure, patients are monitored for a short period and can usually resume their normal activities within a few days. Regular follow-up appointments are scheduled to assess the healing process and monitor for any complications.

Latest Advancements and Success Rate:

In recent years, there have been advancements in percutaneous sclerotherapy techniques for aneurysmal bone cysts.
These include the use of newer sclerosing agents, such as absolute ethanol-soaked sponges or gelfoam, to achieve better and more controlled delivery of the sclerosing agent.
The success rate of percutaneous sclerotherapy for aneurysmal bone cysts has been reported to be approximately 70% to 90%.
Factors such as the size and location of the cyst, as well as the choice of sclerosing agent, can influence the outcomes.
In some cases, multiple sclerotherapy sessions may be required to achieve complete resolution.

Conclusion:

Percutaneous sclerotherapy has emerged as an effective and less invasive treatment option for aneurysmal bone cysts. This procedure offers several advantages, including minimal morbidity, preservation of the affected bone, and a high success rate.
However, it is important to consult with a healthcare professional experienced in the management of aneurysmal bone cysts to determine the most suitable treatment approach based on individual patient factors.

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