Background Sclerotherapy is currently one of the main therapies used in venous and macrocystic lymphatic malformations. Only a few hospitals offer bleomycin as an alternative to treat vascular malformations. Our hospital has used this drug since 2012.
Purpose The aim of this study was to assess the use of bleomycin in vascular malformations after 2 years of use.
Material and methods Our survey was a retrospective study of patients receiving an injection of bleomycin. A data collection form was developed. The amount injected was determined by the size of the malformation (posology was a maximum of 1 mg/kg, without exceeding 15 mg per session).
Results 30 patients were included. Average age was 19 years (5–44): 40% were <15 years old, 40% were 15–25 years old and 20% were >25 years old. The sex ratio was 1/3 (M/F).
The head was the most frequently affected area (45%), then the legs, and the arms, which were less frequently affected. Among the 30 patients included, 69% had an isolated venous vascular malformation and 16% a venous vascular malformation coupled with a syndrome.
Patients received an average of 9 mg (2–15) of bleomycin per session with an average of 2 therapy sessions. Time lapse between 2 sessions was about 3–6 months. 75% of patients had a positive evolution of their malformation while 25% had a poor response.
Few adverse effects were identified, the main ones being post injection fatigue and nausea, local swelling and inflammation. No major complications, especially pulmonary fibrosis, were observed.
The current protocol of bleomycin is too interindividual; the second injection is planned only if patients feel they need it. A new protocol has been implemented at the neuroradiology department. For each new patient, 2 systematic injections (1 mg/kg) at an interval of 6 weeks are now provided. The post assessment sclerotherapy is performed 2 months after, using a clinical examination and Doppler.
Conclusion The results of our study were similar to those found in the published scientific literature. Bleomycin sclerotherapy has a major interest in vascular malformations. It was found to be safe as there were no serious complications observed.
References and/or Acknowledgements All rights reserved.
No conflict of interest.
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