Objectives: To determine the predictive factors for good response outcome of venous (VMs) and lymphatic malformations (LMs) by percutaneous sclerosing therapy and to compare the complications associated with bleomycin versus alcohol treatment.
Methods: A retrospective analysis of 225 patients with lymphatic and venous malformation who had treated by percutaneous sclerotherapy using alcohol and/or bleomycin was performed The treatment outcome was graded from 0-3, in orderly of clinical responsiveness by using visual assessment of changing in size and subjective improvement of symptoms. Predictive factors of good treatment outcome were determined by uni- and multivariate analysis which were conducted on sex, age, onset of disease, location, type, characteristic of lesion and sclerosant usage.
Results: Of 225 patients, 87.6% were VMs and 12.4% were LMs. VMs were predominating in female (6.2:3.8). Between ethanol and bleomycin, there was no statistical significant of treatment sessions, dose and treatment outcome. (p= .42) Sclerosing therapy provided better response on VMs than LMs. (49.2% and 21.4% respectively, p=.002), and had more effective on focal lesions than diffuse patterns (64.9% and 26.1% respectively p<.001) The gender, onset of disease, locations, characteristic on venography and preceding treatment showed no correlation with treatment result. Major complications of ethanol occurred in 38.6%,including hematuria, gangrene, facial paralysis, pulmonary embolism and death. Minor adverse reactions of bleomycin encountered in 19.8% with hyperpigmentation, flu-like symptom and localized fibrosis.
Conclusion: Both absolute alcohol and bleomycin were effective sclerosing agents for percutaneous treatment of venous malformations, but no serious complications encountered with bleomycin. The characteristic of focal single lesion, at any region of body part, can be a predictor for good response.
Predictive Factors for Successful Percutaneous Sclerotherapy of Venous and Lymphatic Malformations
