Efficacy of intra-lesional alcohol injection as alternative and/or complementary treatment of vascular malformations: A systematic review

Prasetyono, Theddeus O.H.; Kreshanti, Prasetyanugraheni

doi:10.1016/j.bjps.2009.04.020

Cited by 33 publications

(22 citation statements)

References 31 publications

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“…However, ethanol had a high rate of complications associated with its use as a sclerosing agent including acute blistering, deep ulceration, haemaglobinuria, and motor or sensory nerve injury [19,21]. Skin complications are the most common, reported as high as 21.1% [22]. Major complications of ethanol include pulmonary hypertension, pulmonary embolus, cardiovascular collapse, rhabdomyolysis, consumptive coagulopathy, and anaphylaxis [21].…”

Section: Discussionmentioning

confidence: 98%

Intralesional bleomycin injection in management of low flow vascular malformations in children

Mohan

Adams²,

Adams³

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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Low flow vascular malformations are challenging to manage, particularly with their propensity to grow, and can lead to severe disfigurement and dysfunction. Traditional surgical excision is fraught with tedious dissection and complications, particularly in the head and neck region. Trends toward less invasive techniques, such as intralesional sclerotherapy, are proving to be successful independent treatments or adjuncts in management in low flow vascular malformations. This study was a retrospective case note review, over an 8-year period, reporting the outcomes of 32 children (mean = 5.8 years, range = 5 months-11.5 years) with radiologically confirmed low flow vascular malformations, treated with serial intralesional bleomycin injection (IBI) therapy. Patient demographics, lesion characteristics, imaging findings, treatment course, radiological and clinical response to treatment were recorded. An overall 91% (n = 29) response rate was achieved, with 28% obtaining complete resolution for low flow vascular malformations. Lesions were sub-categorized into venous malformation, including mixed venous-capillary (n = 27) or lymphatic malformation (LM) (n = 5). Twenty-seven of 32 children experienced no complications. Local complications included superficial skin infection (n = 2), skin necrosis (n = 1), hyperpigmentation, and minor contour deformity. There was no recurrence and no systemic side-effects to bleomycin. Mean follow-up was 38 months (range = 6-95 months). In conclusion, serial intralesional bleomycin injections can be effective and also safe in a paediatric population for the successful management of symptomatic or disfiguring low flow vascular malformations.

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Section: Discussionmentioning

confidence: 98%

Intralesional bleomycin injection in management of low flow vascular malformations in children

Mohan

Adams²,

Adams³

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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“…Surgery has partially lost its central role in the management of the Infantile Hemangiomas in favour of local, systemic therapies or lasers in dangerous areas. [8][9][10][11][12][13] However 14 The surgical way often requires some complementary treatments, to maximize the final results in a multidisciplinary approach. 15 The correct diagnosis and classification of the type of malformation we are facing, do indicate the therapeutic option among a wide range of possibility.…”

Section: Discussionmentioning

confidence: 99%

The Use of Interstitial Echo-Guided Diode Laser 980-nm for Deep Vascular Anomalies in Pediatric Patients: A Preliminary Study

Santecchia

Valassina

Ciprandi

et al. 2013

Surgical Techniques Development

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A wide range of therapeutic options is available to treat vascular anomalies, arising from the systemic therapies to surgery or using lasers. The purpose of this preliminary study is to assess the effectiveness of treatment of vascular anomalies anywhere in the body, along with the use of interstitial echo-guided 980 nm diode laser. The analysis occurs through accurate angio magnetic resonance imaging (MRI) pre-and post-treatment measurements. We enrolled all the patients (16) affected on vascular malformations everywhere in the body, treated from January to August 2012. We obtained excellent results in 6 patients (37.5%) with mean mass reduction of 85%, good in 9 patients (56%) with mean mass reduction of 65% and unsatisfactory in 1 patient (6%). In pediatric patients, low-flow vascular malformations resistant to progressive sclerotherapy or in critical anatomical sites, benefit of echo guided interstitial 980-nm diode laser.

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“…This fracture will promote platelet adhesion and thrombosis and will inhibit further secretion of angiogenesis factors causing permanent occlusion of the exposed vessels and prohibiting further neovascularization. 29 However, for this to happen, the vessel wall has to be sufficiently exposed to high concentrations of ethanol for a certain amount of time. This can be optimized by techniques for controlling the inflow and the outflow of the lesion.…”

Section: Ethanolmentioning

confidence: 99%

New Treatment Approaches to Arteriovenous Malformations

Gilbert

Dubois

Giroux

et al. 2017

Semin intervent Radiol

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Arteriovenous malformations (AVMs) are high-flow vascular anomalies that have demonstrated a very high recurrence rate after endovascular treatment, surgical treatment, or a combination of both. Surgical treatments have shown good response when they are small and well localized but a poor response when diffuse. A better understanding of the nature of the lesion has led to a better response rate and a safer treatment for these patients. This has been accomplished through a detailed understanding of the angioarchitecture of the lesion, enabling a tailored approach in reaching and targeting the nidus of the AVM with different liquid embolic agents, more specifically ethanol. Flow reduction techniques help in exposing the nidus to sclerosant agents. A clinical classification, the Schobinger classification, will help determine the appropriate time to start or to pursue therapy.

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Efficacy of intra-lesional alcohol injection as alternative and/or complementary treatment of vascular malformations: A systematic review

Cited by 33 publications

References 31 publications

Intralesional bleomycin injection in management of low flow vascular malformations in children

Intralesional bleomycin injection in management of low flow vascular malformations in children

The Use of Interstitial Echo-Guided Diode Laser 980-nm for Deep Vascular Anomalies in Pediatric Patients: A Preliminary Study

New Treatment Approaches to Arteriovenous Malformations

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