The experimental rationale for new bleomycin-polidocanol mini-foam administration in the treatment of children with head and neck venous malformations

2021 ◽  
Vol 21 (3) ◽  
pp. 158-162
Author(s):  
L. V. Voznitsyn ◽  
O. Z. Topolnitsky ◽  
G. T. Yermukhanova
Keyword(s):  
Head And Neck ◽  
Venous Malformation ◽  
Vascular Wall ◽  
Treatment Method ◽  
Abnormal Development ◽  
Venous Malformations ◽  
Peripheral Vascular ◽  
Foam Sclerotherapy ◽  
Group 3

Relevance. Venous malformation (VM) is an abnormal development of the collecting blood vessels based on the vascular wall formation disorder, which occurs during the peripheral vascular network differentiation. According to various sources, VM prevalence ranges from 1 to 2 in 10 000 newborns. Head and neck VMs significantly reduce patients’ quality of life, causing severe functional and aesthetic impairments. Sclerotherapy is an effective treatment method for children with venous malformations. In recent years, bleomycin has been the most commonly used sclerosant. It is a glycopeptide antibiotic synthesized by Streptomyces verticillus and belongs to cytostatic medications. They successfully use it for venous malformations sclerotherapy, also in children. Purpose – the study aimed to improve the sclerotherapy method by combining the advantages of foam sclerotherapy and bleomycin.Materials and methods. 48 samples of rats’ external femoral veins were morphologically examined. We divided the rats into 2 groups depending on the administrated agent: the first group – 3% polidocanol (lauromacrogol 400), the second group – bleomycin-polidocanol mini-foam composition. The histological assessment identified the changes in the vein endothelium, necrosis of tissue structures, cell dystrophy characteristics.Results. The first group, which used the bleomycin-polidocanol mini-foam composition, demonstrated more pronounced irreversible changes in the venous vessel endothelium compared to the second group.Conclusions. The experimental study revealed that the proposed method of VM sclerotherapy using new bleomycin-polidocanol mini-foam composition is more effective than the polidocanol foam sclerotherapy. The new method is highly effective, minimally invasive, safe and can be considered an independent treatment method in children with head and neck VM.

Intramuscular venous malformations of the calf: Surgical treatment outcomes of 57 patients

2020 ◽  
Vol 35 (8) ◽  
pp. 597-604
Author(s):  
Claude Laurian ◽  
Pierre Cerceau ◽  
Nikos Paraskevas ◽  
Claudine Massoni ◽  
Veronique Marteau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Venous Malformation ◽  
Functional Limitation ◽  
Venous Malformations ◽  
Complete Excision ◽  
Muscle Involvement ◽  
Residual Functional

Objectives To report the outcomes of surgical treatment of calf intramuscular venous malformations (IMVMs) on pain, functional limitation, and quality of life. Methods We retrospectively reviewed 57 consecutive patients who had surgery for IMVM of the posterior compartment of the leg between 2010 and 2015. Treatments were all done at a single institution. Results Patients presented with pain (52), muscle contracture (14), or pulmonary embolism (4). Muscle involvement included the soleus muscle (n = 28, 49%), the gastrocnemius muscle (n = 25, 43%), and deep muscles (n = 4, 7%). Complete excision was possible in 52 patients (91%) and partial excision in 5 (9%). Thirty-five of 46 patients who had an MRI follow-up at six months had no residual venous malformation. At the final follow-up (mean 39 months), 32 of 40 patients seen had no residual pain and 37 had no residual functional impairment. Conclusion In cases where IMVM is located in one muscle in the leg, we demonstrated that surgery yielded improvement in pain, function, and quality of life.

Quality of life after endovascular sclerotherapy of low-flow venous malformations: the efficacy of polidocanol compared with ethanol

2017 ◽  
Vol 59 (8) ◽  
pp. 946-952 ◽  
Author(s):  
Annamaria Weitz-Tuoretmaa ◽  
Leo Keski-Nisula ◽  
Riitta Rautio ◽  
Jussi Laranne
Keyword(s):  
Quality Of Life ◽  
Venous Malformation ◽  
Post Treatment ◽  
Low Flow ◽  
Venous Malformations ◽  
Limited Information ◽  
Ethanol Group ◽  
Clinical Complications ◽  
Ethanol Sclerotherapy

Background Limited information is available on mid-term results and quality of life (QOL) after endovascular sclerotherapy of venous malformations. Purpose To compare two agents—polidocanol and ethanol—with a focus on the influence on QOL after sclerotherapy. Material and Methods Forty-one consecutive patients with a venous malformation in the head and neck area or in the extremities were treated with polidocanol between 2008 and 2013. Pre- and post-treatment magnetic resonance imaging (MRI) scans were compared. All patients completed a self-evaluation form on symptoms as well as a QOL questionnaire. The results were compared with previously obtained material during 1991–2001, comprising 44 consecutive, similarly located venous malformation patients subject to ethanol sclerotherapy. Results No significant clinical complications were observed. Subjectively, 19 (46%) of the patients benefitted from the treatment. QOL results showed that 85% of patients had an index < 39 – where 0 represents the highest and 100 the lowest QOL. Patients in the ethanol group had marginally better overall post-treatment QOL results. Post-treatment MRI in 35 patients showed the size of the malformation unchanged in 19 (54%) patients, in ten (29%) there was a decrease (<50%) while in six (17%) the decrease was more significant (>50%). Post-treatment MRI results did not correlate with either subjective symptoms or QOL results. Conclusion Polidocanol sclerotherapy were found to be an effective, safe, and well tolerated treatment option for low flow venous malformations. Routine MRI for follow-up appears redundant and may be omitted.

scholarly journals Treatment of Head and Neck Venous Malformations with Sodium Tetradecyl Sulfate

OTO Open ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 2473974X1879706 ◽  
Author(s):  
Ebrahim Karimi ◽  
Mehrdad Jafari ◽  
Keyvan Aghazadeh ◽  
Saeed Sohrabpour ◽  
Fatemeh Tavakolnejad
Keyword(s):  
Head And Neck ◽  
Venous Malformation ◽  
Case Series ◽  
Neck Surgery ◽  
Lesion Size ◽  
Sodium Tetradecyl Sulfate ◽  
Venous Malformations ◽  
Medical Sciences ◽  
Before And After

Objective The purpose of this study was to discuss the clinical outcomes and complications of treating venous malformations with sclerotherapy, with sodium tetradecyl sulfate as the sclerosing agent. Study Design Case series with planned data collection. Setting Amiralam Hospital—a referral otolaryngology–head and neck surgery hospital affiliated with Tehran University of Medical Sciences. Subjects and Methods A total of 345 patients with venous malformations were treated with sclerotherapy with sodium tetradecyl sulfate 3% (1 mL for every 1 cm3 of the lesion). The venous malformation location, treatments before the current sclerotherapy with sodium tetradecyl sulfate, the number of sclerotherapy sessions, and complications resulting from sclerotherapy were recorded. Follow-up assessments were done for a minimum of 1 year following the procedure. A favorable outcome was defined as a 50% decrease in the lesion size based on clinical and radiologic assessments. Results A total of 759 injection sessions were documented, ranging from 1 to 6 injections per patient (mean = 3.1). The follow-up duration ranged from 12 to 84 months (mean = 55 months). Based on clinical assessment, a 50% reduction of size was reported for 95.6% of the patients. According to the imaging before and after the procedures, a 50% reduction of size was seen among 67.3% of the patients. Conclusion The results of the study showed that the use of sodium tetradecyl sulfate as a sclerosing substance can effectively reduce the size of venous malformation lesions.

scholarly journals A Case Report of Bulky Venous Malformation in the Parapharyngeal Space

2020 ◽  
Vol 03 (01) ◽  
pp. e10-e15
Author(s):  
Yuki Sato ◽  
Takao Hamamoto ◽  
Takashi Ishino ◽  
Tsutomu Ueda ◽  
Masay Takumida ◽  
...  
Keyword(s):  
Head And Neck ◽  
Signal Intensity ◽  
Parapharyngeal Space ◽  
Vascular Malformations ◽  
Venous Malformation ◽  
Multimodality Treatment ◽  
High Signal ◽  
Venous Malformations ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced

AbstractVenous malformations commonly occur in the head and neck regions, in the mucous membrane of the nasal and oral cavities. Venous malformations are found in the extremities in 40% of cases, in the trunk in 20% of cases, and in the cervicofacial area in 40% of cases. However, they are rarely encountered in the parapharyngeal space. We report our experience of surgical treatment of a patient with this rare tumor. The patient was a 21-year-old man who presented with a left mandibular swelling and was admitted to a nearby hospital. He was referred to our hospital for examination and treatment. Contrast-enhanced computed tomography (CT) revealed a bulky tumor with some calcification in the parapharyngeal space; on contrast-enhanced CT, the tumor showed some enhanced effects in the arterial and venous phases. Additional enhancement magnetic resonance imaging (MRI) showed the lesion as low signal intensity on T1-weighted images and as high signal intensity on T2-weighted images, and contrast-enhanced MRI showed some enhanced effects of the lesion. Based on these findings, we suspected venous malformation and performed surgical excision. Histopathology confirmed the venous malformation, and the lesion was diagnosed as a cavernous angioma. Vascular malformations in the head and neck regions should be precisely diagnosed so that appropriate multimodality treatment can be undertaken.

Combined treatment of large head and neck capillaro-venous malformation by a fibrosing agent

1989 ◽  
Vol 103 (4) ◽  
pp. 390-398 ◽  
Author(s):  
M. Fradis ◽  
L. Podoshin ◽  
J. Simon ◽  
N. Lazarov ◽  
I. Shagrawi ◽  
...  
Keyword(s):  
Head And Neck ◽  
Venous Malformation ◽  
Combined Treatment ◽  
Neck Region ◽  
Venous Malformations ◽  
Head And Neck Region ◽  
Large Head ◽  
Neck Area

AbstractWe report our experience of seven cases suffering from capillaro-venous malformation localized in the head and neck area, treated preoperatively by a fibrosing agent—ETHIBLOC. Four of the cases are presented and analysed.We suggest the pre-operative injection of Ethibloc as the treatment of choice for capillaro-venous malformations in the head and neck region

Management of venous malformations in Klippel–Trenaunay syndrome with ultrasound-guided foam sclerotherapy

2005 ◽  
Vol 20 (2) ◽  
pp. 63-81 ◽  
Author(s):  
B McDonagh ◽  
S Sorenson ◽  
A Cohen ◽  
T Eaton ◽  
D E Huntley ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Venous Malformation ◽  
Limb Lengthening ◽  
Venous Malformations ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
History Of ◽  
Deep Vein ◽  
Klippel Trenaunay Syndrome

Objective: To study the clinical profile of Klippel–Trenaunay syndrome (KTS) and the management of venous malformations (VMs) with ultrasound-guided foam sclerotherapy using the compass technique. Methods: In this open prospective series, 11 consecutive patients with KTS seeking therapy at a phlebology group practice were included. Seven (64%) of them were post-surgical recurrences. Results: Pain was the commonest presenting complaint (100%), accompanied with VMs/ varicose veins in all except one (91%). Chronic venous insufficiency (CVI) was seen in seven (64%). Soft tissue and bone deformity was present in all (100%). Limb lengthening was frequent and detected in eight (73%), thickening in six (54%); unusually, one patient (9%) presented with severe thinning and shortening of the leg. Venous malformation was the primary vascular problem in nine patients (82%), with capillary malformation (CM)/port wine stain in seven (64%) and isolated lymphatic malformation (LM) in two (18%). The lateral embryonic/Klippel–Trenaunay (KT) vein was detected in 10 patients (91%). Deep vein deformity was not detected in any of them. All the deformities were of the lower limb (100%), while two (18%) had deformities of the thorax and one (9%) had gastrointestinal (GI) malformation. None of the patients gave family history of KTS, while five (45%) had history of varicosities in the family. Eight patients (73%) completed the therapeutic plan with a mean follow-up of 5±3.9 years. An excellent to good type result could be documented in six of the eight cases (75%). These patients had an event-free, good quality of life. Follow-up duplex studies revealed the evolving refluxing tracts requiring sequential therapies. Conclusions: The results in this series demonstrate the utility of foam sclerotherapy using the compass technique in the management of KTS. Chronicity of the VMs in KTS necessitates strict clinical monitoring and sequential therapies.

Sclerotherapy in venous malformation

2013 ◽  
Vol 28 (1_suppl) ◽  
pp. 188-191 ◽  
Author(s):  
E Rabe ◽  
F Pannier
Keyword(s):  
Side Effects ◽  
Effective Treatment ◽  
Multidisciplinary Approach ◽  
Venous Malformation ◽  
Standard Of Care ◽  
Low Flow ◽  
Venous Malformations ◽  
Foam Sclerotherapy ◽  
Effective Treatment Option ◽  
Reduction Of Pain

Venous malformations are the result of an arrested development of the venous system during the embryogenesis. In the treatment of venous malformations the standard of care is a multidisciplinary approach including the use of traditional surgical therapy if applicable and endovascular treatment. Endovascular techniques include embolization therapy for instance with coils but also sclerotherapy with liquid or foamed sclerosants. The aim of this paper is to give an overview of foam sclerotherapy in venous malformations. Sclerotherapy of venous malformations has been performed in superficial and intramuscular malformations. In many cases ethanol has been used for the treatment. Since more than 10 years, less aggressive sclerosants like polidocanol and sodiumtetradecyl sulphate have been used to treat venous malformations. These substances can be used without anaesthesia and the rate of side-effects is much lower. Yamaki and Cabrera are the first who used foam sclerotherapy for the treatment of symptomatic venous malformations. Compared with liquid sclerotherapy foam sclerotherapy has the advantage of a better and longer lasting contact of the sclerosing agent with the vessel wall which leads to a more effective treatment and to a reduction of concentrations needed. In a recent European Guideline on Sclerotherapy foam sclerotherapy is recommended over liquid therapy for the treatment of venous malformations. Foam sclerotherapy is an effective treatment option for low flow extratruncular and truncular venous malformations. Foam is significantly more effective than liquid sclerotherapy and side-effects with polidocanol or sodiumtetradecyl sulphate foam are less compared with sclerotherapy with ethanol. With foam sclerotherapy a significant reduction of pain and volume of the venous malformations can be reached.

scholarly journals Assessment of Quality of Life among Head and Neck Cancer Patients

2020 ◽  
Vol 6 (1) ◽  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Treatment Method ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Before And After ◽  
Oncology Center

Objective: Head and neck cancer is a common malignancy with increasing incidence worldwide. This study evaluates the quality of life of the patients undergoing treatment at the oncology center in Yazd, Iran. Methods: This cross-sectional study was conducted on 29 patients with oral and head and neck cancer that were referred to the oncology center of Shahid Sadoughi hospital in Yazd between May 2015 and February 2016. Data were collected using the UW-QOL questionnaire and a demographic questionnaire. The illness-related information was obtained from the patients’ medical records. Questionnaires were administered before the treatment and 6 months after its completion. Data analysis was performed in SPSS 21 using chi-square and ANOVA tests. P-values of less than 0.05 were considered statistically significant. Results: The sample consisted of 17 (58.6%) women and 12 (41.4%) men with a mean age of 40.00±14.30 years. The most frequent cancer location was the oral cavity and the most frequent treatment method was surgery. The mean score of quality of life before and after treatment was 12.60±2.81 and 11.39±2.63 respectively. The most important issues of the patients before and after treatment were pain and saliva respectively. Stage 3 and 4 patients had a significantly lower quality of life than stage 1 and 2 patients. Conclusion: The study found that undergoing treatment affects some dimensions of quality of life. Hence, choosing the best treatment method with due attention to side effects and follow-up sessions is recommended.

European guidelines for sclerotherapy in chronic venous disorders

2013 ◽  
Vol 29 (6) ◽  
pp. 338-354 ◽  
Author(s):  
E Rabe ◽  
FX Breu ◽  
A Cavezzi ◽  
P Coleridge Smith ◽  
A Frullini ◽  
...  
Keyword(s):  
Medical Literature ◽  
Task Force ◽  
Varicose Veins ◽  
German Society ◽  
Evidence Based ◽  
Venous Malformations ◽  
Foam Sclerotherapy ◽  
European Guidelines ◽  
Venous Disorders

Aim Sclerotherapy is the targeted chemical ablation of varicose veins by intravenous injection of a liquid or foamed sclerosing drug. The treated veins may be intradermal, subcutaneous, and/or transfascial as well as superficial and deep in venous malformations. The aim of this guideline is to give evidence-based recommendations for liquid and foam sclerotherapy. Methods This guideline was drafted on behalf of 23 European Phlebological Societies during a Guideline Conference on 7–10 May 2012 in Mainz. The conference was organized by the German Society of Phlebology. These guidelines review the present state of knowledge as reflected in published medical literature. The regulatory situation of sclerosant drugs differs from country to country but this has not been considered in this document. The recommendations of this guideline are graded according to the American College of Chest Physicians Task Force recommendations on Grading Strength of Recommendations and Quality of Evidence in Clinical Guidelines. Results This guideline focuses on the two sclerosing drugs which are licensed in the majority of the European countries, polidocanol and sodium tetradecyl sulphate. Other sclerosants are not discussed in detail. The guideline gives recommendations concerning indications, contraindications, side-effects, concentrations, volumes, technique and efficacy of liquid and foam sclerotherapy of varicose veins and venous malformations.

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