OUTCOME OF PERCUTANEOUS SCLEROTHERAPY BY BLEOMYCIN IN TREATING VENOUS AND LYMPHATIC MALFORMATIONS

Abstract

Background: Venous and lymphangiomalformations are congenital low-flow vascular malformations which can lead to pain, cosmetic deformity, functional impairment and compression of surrounding structures. The synopsis used in this study is the one approved by the CPSP for the evaluation of the use of ultrasound-guided percutaneous sclerotherapy of these lesions with bleomycin. Objectives: To compare clinical and radiological results of ultrasound-guided percutaneous sclerotherapy with bleomycin before and after treatment in patients with venous malformations versus patients with lymphatic malformations. Methods: 60 patients who were aged 2 months to 17 years and had an ultrasound diagnosis of venous or lymphatic malformation. Intralesional bleomycin sclerotherapy was performed under ultrasound guidance and the patients were followed for 6 months. The outcomes were reduction in lesion size greater than 50%, improvement in pain (VAS score) and cosmetic improvement (POSAS observer score). Results: The mean age was 7.8 ± 4.6 years; 34 patients were male and 26 were female. Venous malformations were present in 35 patients and lymphatic malformations in 25. Mean VAS score decreased from 6.4 ± 1.5 before treatment to 2.3 ± 1.2 after 6 months. Lesion size reduction greater than 50% was observed in 43 patients. Cosmetic improvement was documented in 46 patients. Minor transient swelling occurred in 8 patients, while no major complication was recorded. Conclusion: Ultrasound-guided bleomycin sclerotherapy seems to be an effective and safe treatment for venous and lymphatic malformations.