Comparison between absolute ethanol and bleomycin for the treatment of venous malformation in children

Zhang,Jing; Li,Hai-Bo; Zhou,Shao-Yi; Chen,Kun-Shan; Niu,Chuan-Qiang; Tan,Xiao-Yun; Jiang,Yi-Zhou; Lin,Que-Qing

doi:10.3892/etm.2013.1144

August 2013 Volume 6 Issue 2

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

August 2013 Volume 6 Issue 2

Full Size Image

Article

Comparison between absolute ethanol and bleomycin for the treatment of venous malformation in children

Authors:
- Jing Zhang
- Hai-Bo Li
- Shao-Yi Zhou
- Kun-Shan Chen
- Chuan-Qiang Niu
- Xiao-Yun Tan
- Yi-Zhou Jiang
- Que-Qing Lin
View Affiliations / Copyright

Affiliations: Department of Interventional Radiology and Vascular Anomalies, Guangzhou Women and Children's Medical Center, Guangzhou 510120, P.R. China
Pages: 305-309
|
Published online on: June 5, 2013

https://doi.org/10.3892/etm.2013.1144
Expand metrics +

Abstract

The aim of this study was to investigate the therapeutic efficacies and treatment effects of absolute ethanol and bleomycin for the treatment of venous malformation (VM) in children. A total of 138 children with VM were randomly divided into two groups; 75 patients were treated with absolute ethanol, while a further 63 were treated with bleomycin under general anesthesia between February 2009 and February 2012. The treatment outcome and complications were observed in the two groups and the treatment efficacy was classified as one of four categories: cured, markedly effective, effective and ineffective. The curative effect was analyzed 6-24 months after treatment, with a mean of 15 months. Absolute ethanol was effective (cured, markedly effective or effective) in 71 cases and bleomycin was effective in 41 cases, and the difference between the effective rates was considered to be statistically significant (χ2=19.6, P<0.05). In the absolute ethanol group there were 14 cases with skin necrosis, 17 patients had serious localized swelling which required additional treatment, three patients developed muscle fibrosis and one patient suffered a brain embolism. In the bleomycin group there were five cases with skin necrosis and the difference in the incidence of adverse reactions was considered to be statistically significant (χ2=18.8, P<0.05). The curative effect of sclerotherapy for VM is clear, and absolute ethanol is the most effective sclerosing agent, but has a greater incidence of adverse side‑effects than bleomycin. The major side‑effect is skin necrosis. The choice of sclerotherapy depends on the classification of VM in children.

View Figures

View References

1.	Fishman SJ and Mulliken JB: Hemangiomas and vascular malformations of infancy and childhood. Pediatr Clin North Am. 40:1177–1200. 1993.PubMed/NCBI
2.	Greene AK and Alomari AI: Management of venous malformations. Clin Plast Surg. 38:83–93. 2011. View Article : Google Scholar
3.	Belov S and Loose DA: Surgical treatment of congenital vascular defects. Int Angiol. 9:175–182. 1990.PubMed/NCBI
4.	Yun WS, Kim YW, Lee KB, et al: Predictors of response to percutaneous ethanol sclerotherapy (PES) in patients with venous malformations: analysis of patient self-assessment and imaging. J Vasc Surg. 50:581–589. 2009. View Article : Google Scholar : PubMed/NCBI
5.	Orlando JL, Caldas JG, Campos HG, et al: Ethanol sclerotherapy of superficial venous malformation: a new procedure. Dermatology. 220:376–380. 2010. View Article : Google Scholar : PubMed/NCBI
6.	Ierardi AM, Mangini M, Vaghi M, et al: Sclerotherapy of peripheral venous malformations: a new technique to prevent serious complications. Vasc Endovascular Surg. 44:282–288. 2010. View Article : Google Scholar : PubMed/NCBI
7.	Chen WL, Yang ZH, Bai ZB, et al: A pilot study on combination compartmentalisation and sclerotherapy for the treatment of massive venous malformations of the face and neck. J Plast Reconstr Aesthet Surg. 61:1486–1492. 2008. View Article : Google Scholar : PubMed/NCBI
8.	Lee CH and Chen SG: Direct percutaneous ethanol instillation for treatment of venous malformation in the face and neck. Br J Plast Surg. 58:1073–1078. 2005. View Article : Google Scholar : PubMed/NCBI
9.	Chinese Medical Association: Clinical Practice Guidelines - Plastic Surgery volumes. Beijing: People’s Health Publishing House; pp. 11–12. 2009
10.	Su L, Fan X, Zheng L and Zheng J: Absolute ethanol sclerotherapy for venous malformations in the face and neck. J Oral Maxillofac Surg. 68:1622–1627. 2010. View Article : Google Scholar : PubMed/NCBI
11.	Spence J, Krings T, TerBrugge KG and Agid R: Percutaneous treatment of facial venous malformations: a matched comparison of alcohol and bleomycin sclerotherapy. Head Neck. 33:125–130. 2011. View Article : Google Scholar : PubMed/NCBI
12.	Khandpur S and Sharma VK: Utility of intralesional sclerotherapy with 3% sodium tetradecyl sulphate in cutaneous vascular malformations. Dermatol Surg. 36:340–346. 2010.PubMed/NCBI
13.	Rautio R, Laranne J, Kähärä V, et al: Long-term results and quality of life after endovascular treatment of venous malformations in the face and neck. Acta Radiol. 45:738–745. 2004. View Article : Google Scholar : PubMed/NCBI
14.	Sainsbury DC, Kessell G, Fall AJ, et al: Intralesional bleomycin injection treatment for vascular birthmarks: a 5-year experience at a single United Kingdom unit. Plast Reconstr Surg. 127:2031–2044. 2011.PubMed/NCBI
15.	Berenguer B, Burrows PE, Zurakowski D and Mulliken JB: Sclerotherapy of craniofacial venous malformations: complications and results. Plast Reconstr Surg. 104:1–11. 1999. View Article : Google Scholar : PubMed/NCBI
16.	Dompmartin A, Vikkula M and Boon LM: Venous malformation: update on aetiopathogenesis, diagnosis and management. Phlebology. 25:224–235. 2010. View Article : Google Scholar : PubMed/NCBI
17.	Barbier C, Martin A, Papagiannaki C, et al: Superficial venous malformations. Presse Med. 39:471–481. 2010.(In French).
18.	Zochowski CG, Salgado CJ and Jamali AA: Extensive muscle necrosis and infection following treatment of a lower extremity vascular malformation with Sotradecol and absolute ethanol. Blood Coagul Fibrinolysis. 21:480–486. 2010. View Article : Google Scholar
19.	Bisdorff A, Mazighi M, Saint-Maurice JP, et al: Ethanol threshold doses for systemic complications during sclerotherapy of superficial venous malformations: a retrospective study. Neuroradiology. 53:891–894. 2011. View Article : Google Scholar : PubMed/NCBI
20.	Wang YA, Zheng JW, Zhu HG, et al: Sclerotherapy of voluminous venous malformation in head and neck with absolute ethanol under digital subtraction angiography guidance. Phlebology. 25:138–144. 2010.
21.	Berber O, Holt P, Hinchliffe R, et al: Endovenous therapy for the treatment of congenital venous malformations. Ann Vasc Surg. 24:e13–e17. 2010. View Article : Google Scholar : PubMed/NCBI
22.	Uehara S, Osuga K, Yoneda A, et al: Intralesional sclerotherapy for subcutaneous venous malformations in children. Pediatr Surg Int. 25:709–713. 2009. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Comparison between absolute ethanol and bleomycin for the treatment of venous malformation in children

This article is mentioned in:

Abstract

Figure 1

Figure 2

Related Articles