Bleomycin for Percutaneous Sclerotherapy of Venous and Lymphatic Malformations: A Retrospective Study of Safety, Efficacy and Mid-Term Outcomes in 26 Patients

Abstract

Percutaneous sclerotherapy is used to treat venous and lymphatic vascular malformations, which can cause significant discomfort and/or disfigurement. The purpose of this study is to describe the bleomycin sclerotherapy technique and to evaluate its clinical and radiological efficacy and safety. We retrospectively identified consecutive patients with venous malformations (VMs) and lymphatic malformations (LMs) who underwent bleomycin sclerotherapy in 2011–2020 at our institution. We collected the clinical and radiological success rates, complications and recurrences separately in the VM and LM groups. We identified 26 patients, 15 with VMs and 11 with LMs. The significant volume reductions obtained were 45% in the VM group and 76% in the LM group (p = 0.003 and p = 0.009, respectively). Significant reductions in discomfort/pain and in cosmetic disfigurement were obtained in both groups. An overall improvement was reported by 69% and 82% of patients in the VM and LM groups, respectively. No major complications occurred during the mean follow-up of 51 ± 34 months in the VM group and 29 ± 18 months in the LM group. A recurrence developed within 2 years in 23% of patients. Bleomycin is clinically and radiologically effective for the treatment of venous and lymphatic malformations, with a high level of patient safety.

Results of interventional treatment of peripheral slow-flow malformations

“…A similar picture is drawn by Gorman et al with an average volume of 156ml and a range of 3-1703ml [7]. Even larger VMs (> 4000ml) were used in the study by Nevesny et al [12].…”

Glue Embolization Without Surgical Resection for Orbital Venolymphatic Malformation

“…Recent literature has demonstrated that sclerotherapy may be ineffective for patients with distensible, venous-dominant moderate-flow OVLM due to frequent recurrence 4. OVLM recurrence rates as high as 23% postsclerotherapy and 58% postsurgical resection have been reported 5,6…”

Large scalp venous malformation in a pediatric patient managed with sclerotherapy and surgery: a case report and review of literature

“…Because much of the volume of low-ow VMs consists of stagnant intraluminal uid, percutaneous sclerotherapy, which can be done with liquid (ethanol, sodium tetradecyl sulfate (STS), bleomycin), semiliquid (NBCA glue, onyx) or solids (particles, absorbable gelatin powder), is widely advocated as the treatment of choice [8,12,[15][16][17][18][19][20]. Surgery is reserved for select cases not amenable to sclerotherapy, VMs that are large and dis guring or for whom embolization alone is insu cient.…”