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

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.

Venous malformations: clinical diagnosis and treatment

“…This could indicate superior results with ethanol and numerous other studies have published similar findings (50,56,(73)(74)(75)(76)(77)(78).…”

“…conducted a statistically significant 138 patient series that stated a 95% effective treatment with ethanol, while only 65% of treatments were effective in the bleomycin group, additionally few cases of skin necrosis was seen in both groups (73). This could indicate superior results with ethanol and numerous other studies have published similar findings (50,56,(73)(74)(75)(76)(77)(78).…”

Intralesional Sclerotherapy Using Absolute Alcohol for Management of Haemangioma

“…The International Society for the Study of Vascular Anomalies Classification divides vascular anomalies into two primary biological categories: (1) Vasoproliferative or vascular neoplasms and (2) Vascular Malformations [11,12]. In our case, the lesion was present in the lips since childhood, and it was gradually increasing in size which can be correlated with the features of haemangioma.…”

Foamed bleomycin sclerosis of airway venous malformations: The role of interspecialty collaboration

“…Bleomycin A2 is the most commonly used form in the United States. Both bleomycin A2 and A5 have been used to treat VMs . Bleomycin A5, also known as pingyangmycin , in particular has a long history of clinical use, particularly in China…”