A prospective randomised trial comparing propranolol and sclerotherapy to sclerotherapy alone was conducted over a 2-year follow up in a district hospital setting of unselected patients. Rebleeding and survival were analysed. Thirty-nine patients were randomised to propranolol plus sclerotherapy and 34 to sclerotherapy alone. The two groups were clinically comparable. There was no significant difference in the cumulative percent of patients free of rebleeding; 54% of the sclerotherapy group rebled compared to 52% of the group treated with propranolol plus sclerotherapy (Hazard ratio 1.09 (0.54-2.22) and p = 0.81, NS). Two-year actuarial survival was also not significantly different, with 77% of the propanolol plus sclerotherapy group surviving, compared to 74% of sclerotherapy alone (Hazard ratio 1.08 (0.35-2.22) and p = 0.79, NS). The mean time to eradication of varices was not significantly different between the two groups (propranolol plus sclerotherapy 222 days, sclerotherapy alone 243 days), nor did the rate of variceal recurrence differ (72.7 vs 72 days). This study did not show long-term improvement in rebleeding or survival using propranolol in addition to a regular sclerotherapy programme.
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Iran J Otorhinolaryngol
January 2024
Otorhinolaryngology Interest Group UEB (ORLIG-UEB), Bogotá, Colombia.
Introduction: Soft tissue hemangiomas are among the most prevalent soft tissue tumors and can pose diagnostic challenges due to their propensity to extend into various regions. In our case, imaging studies facilitated effective characterization of the mass, and timely intervention with sclerotherapy enabled adequate initial control of the lesion. Subsequently, medical management with propranolol and a second scheduled surgical intervention with sclerotherapy contributed to a reduction in the lesion size, alleviation of symptoms, and improvement in prognosis.
View Article and Find Full Text PDFWorld J Gastroenterol
November 2024
Department of Medicine and Surgery, University of Enna 'Kore', Enna 94100, Sicilia, Italy.
Esophageal variceal bleeding is a severe complication often associated with portal hypertension, commonly due to liver cirrhosis. Prevention and treatment of this condition are critical for patient outcomes. Preventive strategies focus on reducing portal hypertension to prevent varices from developing or enlarging.
View Article and Find Full Text PDFOral Maxillofac Surg Clin North Am
August 2024
Department of Otolaryngology-Head and Neck Surgery, University of Washington Medical Center, 1959 Northeast Pacific Street, UW Box 356515, Seattle, WA 98195, USA; Division of Pediatric Otolaryngology-Head and Neck Surgery, University of Washington Medical Center, 1959 Northeast Pacific Street, UW Box 356515, Seattle, WA 98195, USA.
Craniomaxillofacial vascular anomalies encompass a diverse and complex set of pathologies that may have a profound impact on pediatric patients. They are subdivided into vascular tumors and vascular malformations depending on biological properties, clinical course, and distribution patterns. Given the complexity and potential for leading to significant functional morbidity and esthetic concerns, a multidisciplinary approach is generally necessary to optimize patient outcomes.
View Article and Find Full Text PDFFront Surg
May 2023
Department of Pediatric Surgery, Olgahospital, Klinikum Stuttgart, Stuttgart, Germany.
This is a review of two cases of neonatal giant scalp congenital hemangioma. Both patients were treated with propranolol using a similar multi-step approach that included transarterial embolization of the supplying arteries followed by surgical resection of the lesion. In this report, we discuss the treatments, complications, and clinical outcomes of interventions and surgical procedures.
View Article and Find Full Text PDFJ Stomatol Oral Maxillofac Surg
February 2023
Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
Introduction: Propranolol has emerged as a first line agent in the management of hemangiomas. With increased use of propranolol, studies have also focused on relapses following propranolol therapy. Our current study evaluates the role of bleomycin triamcinolone sclerotherapy for the management of propranolol resistant Infantile Hemangioma (IH).
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