Objectives/hypothesis: To assess clinical outcomes of patients with airway venous malformations treated with percutaneous sclerotherapy (VMPS). We highlight the role of foamed bleomycin as a less inflammatory sclerosant and the importance of collaboration between interventional radiology and otolaryngology-head and neck surgery (OHNS).
Study Design: Retrospective, consecutive, single-center series.
Methods: Sixteen airway VMPS treatment sessions were performed (5 patients). Endoscopic needle guidance was performed by OHNS. Sclerosants included ethanol and foamed bleomycin. The following data were tabulated for each patient: hospital length of stay (LOS), clinical response, and the presence/absence of airway swelling requiring prolonged intubation. Univariate analysis was performed. P < 0.05 was considered significant.
Results: Thirty-one percent (5 of 16) of treatments required endoscopic guidance. Eighty-seven percent (7 of 8) of airway VMs treated with ethanol caused significant airway swelling compared to 0% (0 of 8) of airway VMs treated with bleomycin (P = 0.0004). The LOS was significantly greater for ethanol (5 ± 0.3 days) than for bleomycin (1 day, P = 0.001). Ninety-four percent (15 of 16) of airway VM treatments had at least a partial clinical response. There was no significant difference in clinical response between ethanol and bleomycin (P = 0.30).
Conclusion: Endoscopic and image-guided needle placement may be necessary to treat deep airway VMs. Bleomycin may cause less significant airway swelling than ethanol. This may reduce hospital LOS and prolonged intubation. Our results should be interpreted with caution because this is a very small retrospective study. Additional investigation is needed to establish safety and efficacy of foamed bleomycin.
Level Of Evidence: 4. Laryngoscope, 126:2726-2732, 2016.
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http://dx.doi.org/10.1002/lary.26077 | DOI Listing |
Eur J Vasc Endovasc Surg
June 2020
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, Shanghai, PR China. Electronic address:
Objective: This study investigated the in vitro stability of a novel sclerosant, bleomycin polidocanol foam (BPF), for venous malformation (VM) sclerotherapy.
Methods: The study was designed with control groups treated with polidocanol (0.5%, 1%, and 3%) only.
J Vasc Interv Radiol
September 2019
Department of Dermatology, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287.
The present report documents 6 patients who developed distinctive hyperpigmented skin lesions after bleomycin sclerotherapy for vascular malformations of the face, neck, and extremities. The patients ranged in age from 2 to 65 years and included both black and white and male and female patients. The bleomycin treatment dose varied from 15 to 45 U, with 5 of the 6 patients receiving foamed bleomycin.
View Article and Find Full Text PDFLaryngoscope
December 2016
Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.
Objectives/hypothesis: To assess clinical outcomes of patients with airway venous malformations treated with percutaneous sclerotherapy (VMPS). We highlight the role of foamed bleomycin as a less inflammatory sclerosant and the importance of collaboration between interventional radiology and otolaryngology-head and neck surgery (OHNS).
Study Design: Retrospective, consecutive, single-center series.
J Vasc Interv Radiol
October 2015
Divisions of Cardiovascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiologic Science, The Johns Hopkins University School of Medicine, 601 N. Caroline St., Room 3125, Baltimore, MD 21287.
Purpose: To report clinical and radiographic outcomes of patients with venous malformations (VMs) treated with bleomycin foam.
Materials And Methods: Twenty patients (age, 2-68 y) presented with symptoms of swelling (n = 19; 95%), pain (n = 14; 70%), and bleeding (n = 4; 20%). Lesions were located in the head and neck in 17 patients (85%), extremities in two (10%), and mediastinum in one (5%).
Auris Nasus Larynx
November 1986
Silicone foam containing BLM and implanted in the cavity resulting from the resection of a tumor seemed to act against any tumor cells remaining in the resection site in microscopic amounts by slowly releasing this carcinostatic agent. The silicone foam is molded in precise accordance with the shape of the wound surface as it foams and hardens, leaving no space between the material and the wound surface. The carcinostatic agent released can, therefore, act on the entire surface of the wound, and the implantation also has a hemostatic effect.
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