Low-flow vascular malformations of the head and neck: clinicopathology and image guided therapy

Abstract

Low-flow vascular malformations are congenital lesions secondary to errors in the development of veins, capillaries or lymphatics. The majority of these lesions are sporadic although association with heritable syndromes does occur. Patients with these lesions should be treated and evaluated by a multidisciplinary team comprising medical, radiologic and surgical subspecialties. Percutaneous image guided sclerotherapy is gaining acceptance as a firstline treatment of low-flow vascular malformations.

Patient-Reported Outcomes of Bleomycin Sclerotherapy for Low-Flow Vascular Malformations and Predictors of Improvement

“…Bleomycin is a sclerosing agent used for vascular malformations [ 12 , 15 ], that was originally discovered for its cytotoxic and antibiotic properties [ 16 – 18 ]. As clinicians noticed that bleomycin also has a potent sclerosing effect, and may lead to less severe local adverse events (e.g., swelling, nerve injury) than other sclerosing agents [ 19 – 21 ], it is now one of the most frequently used sclerosing agents for vascular malformations [ 8 ]. Previously published observational studies show that bleomycin can reduce the size of both LMs and VMs [ 12 , 15 ].…”

Percutaneous sclerotherapy with ethanolamine oleate for venous malformations of the head and neck

“…These lesions often require treatment to address airway compromise, infection risk, bleeding, or cosmesis 2–4. Treatment of these lesions can be performed with numerous modalities, most frequently surgery, percutaneous sclerotherapy, or both 3 5. Use of numerous sclerosants has been reported in clinical studies, yet no clearly superior agent has been identified 6.…”

Percutaneous sclerotherapy with ethanolamine oleate for lymphatic malformations of the head and neck

“…These lesions can require treatment either for cosmetic issues or for functional reasons, such as airway compromise, infection risk, or bleeding 2–4. Treatment can be approached with numerous modalities, of which percutaneous sclerotherapy has earned an important role 3 5. Several different sclerosing agents have been employed, but no sclerosant has been identified as clearly superior compared with others 6.…”