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

Abstract

PurposeThere is paucity of data on patient-perceived outcomes of bleomycin sclerotherapy for low-flow vascular malformations. In this study, the long-term outcomes of bleomycin sclerotherapy were investigated in terms of quality of life (QoL) and patient-perceived changes in health.Materials and MethodsA cohort of Dutch patients with vascular malformations treated with bleomycin sclerotherapy (June 2010-November 2015) completed a questionnaire evaluating disease symptoms, QoL (Short Form 36), patient-perceived change in health status (Global Rating of Change scales) and treatment satisfaction. QoL was assessed for the patient’s status before and after treatment and was analyzed relative to an age and sex-matched Dutch reference population. Predictive factors associated with QoL and patient-perceived improvement in overall health status were assessed using multivariable linear and logistic regression analyses, respectively.ResultsSeventy-seven patients, with a median follow-up of 22 months, were enrolled. About half of the respondents (49.3%) indicated that they perceived (any form of) improvement in their overall health status. Most often improved were the specific health aspects ‘pain’ (54.5%) and ‘overall severity of symptoms’ (57.1%). No factors were significantly predictive for patient-perceived improvement in health with respect to the vascular malformation. Impairment in work- or study-related activities prior to sclerotherapy was found to negatively impact physical QoL at follow-up (p = 0.03).ConclusionApproximately half of patients with low-flow vascular malformations indicate an improvement in overall health status following bleomycin sclerotherapy, particularly concerning pain and severity of symptoms. However, most patients only perceived little to moderate improvement to their health and desire further treatment.

Quality of life and clinical results after endovascular sclerotherapy: A comparison between intra- and extramuscular low-flow venous malformations

“…On the other hand, majority of patients were willing to have further treatment. 14 Our results are in close concordance to their material, whether treating intra- or extramuscular VMs. It is easy to agree with their reasoning that often the patient’s expectations exceed the outcome that can realistically be expected leading to only moderate patient satisfaction scores.…”

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

“…Thus, only 37% of our patients reported a marked improvement in overall satisfaction. In contrast, in a study where the physicians evaluated the improvement, they found an excellent overall response for 87% of VMs and 84% of LMs [ 16 ]. This discrepancy underlines the importance of collecting patient-reported outcomes.…”

Combined treatment of surgery and sclerotherapy for sinus pericranii

“…Considering the patient's age, a radiologist performed ultrasonographyguided needling, and an anesthesiologist performed sclerotherapy using bleomycin under general anesthesia. Bleomycin is reportedly a safe drug in sclerotherapy, with short-term effects, a good degree of patient satisfaction, and no long-term side effects [10,11]. There was a notable improvement in the lesion following sclerotherapy, and had significantly reduced in size on the follow-up imaging outcomes.…”