Faheem Ul Haq1, Sally E Mitchell2, Aylin Tekes3, Clifford R Weiss1. 1. 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. 2. 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.. Electronic address: smitche@jhmi.edu. 3. Pediatric Radiology and Pediatric Neuroradiology, 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.
Abstract
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%). Twenty-seven embolizations were performed, with a mean of 1.7 ± 1.0 treatments per patient (range, 1-4). An average of 0.45 ± 0.4 U/kg of bleomycin foam was used per procedure, with a range of 0.1-2.3 U/kg. RESULTS: All procedures were technically successful with no intraprocedural complications. Mean follow-up was 66 days ± 80, with a range of 4-403 days. Postprocedure complications were minor in 6 of 27 procedures (22%) and major in 2 of 27 procedures (7%). All 20 patients (100%) reported improvement in their symptoms after a single treatment session. Postprocedural magnetic resonance (MR) imaging demonstrated volume reduction of treated lesions in 13 of 14 patients (93%), with a mean lesion volume reduction of 66% ± 21. Enhancement on MR imaging after treatment was decreased in 11 of 14 patients (79%), increased in two (14%), and stable in one (7%). T2 signal intensity on MR imaging after treatment was decreased in 12 of 14 patients (86%) and stable in two (14%). CONCLUSIONS: The use of bleomycin foam for the percutaneous treatment of VMs is safe and effective. Foaming bleomycin may be used to address the dose limitations of the liquid.
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%). Twenty-seven embolizations were performed, with a mean of 1.7 ± 1.0 treatments per patient (range, 1-4). An average of 0.45 ± 0.4 U/kg of bleomycin foam was used per procedure, with a range of 0.1-2.3 U/kg. RESULTS: All procedures were technically successful with no intraprocedural complications. Mean follow-up was 66 days ± 80, with a range of 4-403 days. Postprocedure complications were minor in 6 of 27 procedures (22%) and major in 2 of 27 procedures (7%). All 20 patients (100%) reported improvement in their symptoms after a single treatment session. Postprocedural magnetic resonance (MR) imaging demonstrated volume reduction of treated lesions in 13 of 14 patients (93%), with a mean lesion volume reduction of 66% ± 21. Enhancement on MR imaging after treatment was decreased in 11 of 14 patients (79%), increased in two (14%), and stable in one (7%). T2 signal intensity on MR imaging after treatment was decreased in 12 of 14 patients (86%) and stable in two (14%). CONCLUSIONS: The use of bleomycin foam for the percutaneous treatment of VMs is safe and effective. Foaming bleomycin may be used to address the dose limitations of the liquid.
Authors: Brian P Holly; Yuval A Patel; James Park; Laura M Fayad; E Gene Deune; Sally E Mitchell; Clifford R Weiss Journal: Hand (N Y) Date: 2016-09-16
Authors: Hannara Park; Jin Soo Kim; Hyochun Park; Ji Yoon Kim; Seung Huh; Jong Min Lee; Sang Yub Lee; Seok Jong Lee; Joon Seok Lee; Jeong Woo Lee; Ho Yun Chung Journal: Arch Plast Surg Date: 2019-01-15