Transperineal approach technique for the treatment of slow-flow perirectal vascular malformations

The transperineal approach provides a safe and effective alternative for treating perirectal vascular malformations, offering excellent anatomic control and reduced morbidity. Combined polidocanol-bleomycin sclerotherapy appears to be a feasible and well-tolerated therapeutic option; however, larger studies are needed to confirm its efficacy and long-term outcomes.Clinical ImpactThe transperineal approach for the management of slow-flow vascular malformations represents a practical, safe, and reproducible therapeutic option that provides minimally invasive access to complex perirectal lesions. By eliminating the need for endoscopic instruments or major surgical procedures, it reduces both procedural risks and associated costs. Its technical simplicity and minimal equipment requirements facilitate its implementation in most vascular centers, broadening access to specialized care across various clinical settings.