A clinical study of ultrasound-guided intralesional injection of bleomycin A5 on venous malformation in cervical-facial region in China

• Published in: Journal of vascular surgery 2010-04, Vol.51 (4), p.940-945
• Main Authors: Hou, Rui, DDS, Guo, Jun, MD, Hu, Kaijin, DDS, Yang, Yaowu, DDS, Wang, Lei, DDS, Kong, Liang, DDS, Liu, Guicai, DDS, Lei, Delin, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Back; Bleomycin - administration & dosage; Bleomycin - adverse effects; Bleomycin - analogs & derivatives; Cardiovascular Agents - administration & dosage; Cardiovascular Agents - adverse effects; China; Drug Administration Schedule; Face; Female; Humans; Injections, Intralesional; Male; Middle Aged; Retrospective Studies; Surgery; Time Factors; Treatment Outcome; Ultrasonography, Interventional; Vascular Malformations - diagnostic imaging; Vascular Malformations - drug therapy; Veins - abnormalities; Veins - diagnostic imaging; Young Adult
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2009.11.038

Objectives To evaluate the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin A5 on treatment of venous malformation (VM) in cervical-facial region. Methods Seventy-five patients (32 male, 43 female), ranging in age from 13 to 60 years old, suffering from VM in cervical-facial region were admitted to and treated at our hospital between June 2006 and February 2007. Of all the patients, 54 malformations were located in the facial region, eight in the submental region, 10 in the submandible region, and three in the cervical region; all were treated by ultrasound-guided intralesional injections of bleomycin A5. The size of the lesions ranged from 6 × 9 mm to 32 × 39 mm. Injection of bleomycin A5 on venous malformation was then carried out through the inspection of ultrasonography. Repeated course of bleomycin A5 injection was administrated for larger malformations. The amount was 8 mg each time. The therapeutic interval was two to four weeks. The therapeutic outcome on venous malformation was evaluated by physical examination and ultrasonography with Doppler according to the Shou standards, including four grades; cured, basically cured, improved, and invalid. The complications were also observed during and after injection. Results The duration of follow-up ranged from 6 to 24 months. The average times of treatment were 1.64 times. Among them, 42 patients (56%) received only one time of treatment, 21 (28%) patients received two times, nine (12%) patients received three times, and three (4%) patients received four times. According to criteria of therapeutic outcome, the results showed cured in 63 patients (84%), basically cured in 10 patients (13.33%), improved in two patients (2.67%), and none ineffective. Seventy-one patients (94.67%) had local swelling in injection region for several days and two patients (2.67%) developed temporary dizziness after treatment. There were no other complications recorded. Conclusions Intralesional injection of bleomycin A5 establishes a promisingly effect way for patients suffering from VM in the cervical-facial region under ultrasound guidance.