Efficacy and safety of transarterial bleomycin sclerotherapy of early-stage facial arteriovenous malformation: Single-center multidisciplinary team experience

초록

Background: To evaluate the efficacy and safety of transarterial bleomycin scle-rotherapy of early-stage facial arteriovenous malformation (AVM). Methods: A retrospective review was performed of patients who underwent bleomycin scle-rotherapy for early-stage AVM (Schobinger stage I or II) in a single-referral vascular anomaliescenter. Bleomycin was slowly infused transarterially with flow control techniques to prolong the effects of bleomycin. Procedure details, AVM characteristics, and previous treatments were re-viewed. Initial therapeutic outcomes were determined by 5 categories using both radiological and clinical findings in a 6-month follow-up. Further follow-up outcomes were reviewed to evaluate the long-term efficacy and safety of the treatment. Procedure-related complications were also analyzed.Results: Nineteen patients (mean age 22.4 +/- 14.0 years, 14 females) with 31 sessions of scle-rotherapies were enrolled. All AVMs were Cho-Do classification type III (type IIIa [ n = 13], type IIIb [ n = 2], and type IIIa + b [ n = 4]). Patients received a mean of 1.6 (range, 1-4) sessions of treatment. The mean cumulative bleomycin dose was 23,600 IU +/- 14,500 (range, 8000 - 60,000 IU). The results showed that 14 patients (74%) were responsive to transarterial bleomycin scle-rotherapy, including complete response ( n = 3), marked improvement ( n = 1), and partial improvement ( n = 10). The remaining 5 (26%) showed no response. During a mean follow-up of 32.6 months, 5 (26%) showed slight progression compared with 6-month outcomes and 14 (74%) were stable. There were only 2 minor complications [hyperpigmentation ( n = 1) and cellulitis ( n = 1)]. Conclusions: Transarterial bleomycin sclerotherapy using flow control techniques can be a safe and feasible alternative treatment option for facial early-stage AVM.(c) 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by El-sevier Ltd. All rights reserved.

키워드