A Proposal for a Scoring System for Hemoglobinuria Following Ethanolamine Oleate Sclerotherapy in Children with Venous Malformations

Ethanolamine oleate (EO) is a sclerosing agent commonly used to treat slow-flow vascular malformations (SFVMs). Macroscopic hemoglobinuria is the most frequent complication of EO sclerotherapy and may occasionally progress to acute renal failure. Because EO was originally developed for adult esophageal and gastric varices, data on its pediatric use remain limited. This study aimed to identify risk factors for macroscopic hemoglobinuria and to develop a practical scoring system to support the safe use of EO in children.