![[ Visit Client Website ]](images/banner.gif)
Monday, October 1, 2018: 4:35 PM
Vascular anomalies are a common occurrence and are found in all age groups and both sexes with equal impunity. All vascular anomalies are categorized into two broad groups namely haemangiomas and vascular malformations. Haemangiomas are vascular tumours with pathologic cell proliferation while malformations on the other hand are comprised of abnormally formed channels within a vascular apparatus lined by endothelial cells that do not undergo cellular turnover.
Vascular malformations gradually grow in size with the patient and slowly achieve large proportions involving and displacing the body tissues like muscle, nerve, bone and hence cause difficulties in surgical excision. Advanced vascular malformations are hence a surgical challenge as the surgeon often has to decide between total surgical excision with loss of function as opposed to partial excision while retaining full function. These malformations often occur in a surgically inaccessible location like deep in the palate, behind the maxilla, inside orbit or sometimes engulf a particular area like the perineum and in these circumstances, surgical excision becomes difficult.
Many pharmacological agents have been used for treating vascular anomalies and amongst these, bleomycin stands out as the most promising agent for such difficult lesions. Bleomycin has been found to be effective in reducing the size and vascularity of the lesions from 50%-70% over a period of 5-6 sessions. The average dose of bleomycin has ranged from 8-15 IU intralesionally. It is most effective in venous and lymphatic lesions especially those that are large in size and located in deep areas. Patient demographics, lesion characteristics, imaging findings, treatment course, radiological and clinical response to treatment were recorded. Lesions were sub-categorized into venous malformation, including mixed venous-capillary (n=29) or lymphatic malformation (LM) (n = 8). One hundred three out of 112 patients experienced no complications. Local complications included superficial skin infection (n=4), skin necrosis (n=5), hyperpigmentation, and minor contour deformity. There was no recurrence and no systemic side-effects to bleomycin. In conclusion, serial intralesional bleomycin injections can be effective and also safe for the successful management of symptomatic or disfiguring vascular malformations and are a great adjunct to surgery.
Vascular malformations gradually grow in size with the patient and slowly achieve large proportions involving and displacing the body tissues like muscle, nerve, bone and hence cause difficulties in surgical excision. Advanced vascular malformations are hence a surgical challenge as the surgeon often has to decide between total surgical excision with loss of function as opposed to partial excision while retaining full function. These malformations often occur in a surgically inaccessible location like deep in the palate, behind the maxilla, inside orbit or sometimes engulf a particular area like the perineum and in these circumstances, surgical excision becomes difficult.
Many pharmacological agents have been used for treating vascular anomalies and amongst these, bleomycin stands out as the most promising agent for such difficult lesions. Bleomycin has been found to be effective in reducing the size and vascularity of the lesions from 50%-70% over a period of 5-6 sessions. The average dose of bleomycin has ranged from 8-15 IU intralesionally. It is most effective in venous and lymphatic lesions especially those that are large in size and located in deep areas. Patient demographics, lesion characteristics, imaging findings, treatment course, radiological and clinical response to treatment were recorded. Lesions were sub-categorized into venous malformation, including mixed venous-capillary (n=29) or lymphatic malformation (LM) (n = 8). One hundred three out of 112 patients experienced no complications. Local complications included superficial skin infection (n=4), skin necrosis (n=5), hyperpigmentation, and minor contour deformity. There was no recurrence and no systemic side-effects to bleomycin. In conclusion, serial intralesional bleomycin injections can be effective and also safe for the successful management of symptomatic or disfiguring vascular malformations and are a great adjunct to surgery.