Digital subtraction angiography-guided percutaneous sclerotherapy of venous malformations with pingyangmycin and/or absolute ethanol in the maxillofacial region.
OBJECTIVE
The present study evaluated the safety and efficacy of digital subtraction angiography-guided percutaneous sclerotherapy of venous malformations (VMs) with pingyangmycin and/or absolute ethanol in the maxillofacial region. We present our safe and novel method for treating venous malformations.


METHODS
A total of 20 patients (21 locations) diagnosed with VMs were enrolled in the present trial. Evaluated by preoperative digital subtraction angiography, the lesions were categorized into 4 types according to the venous drainage features. Of the 20 patients, 5 had type I VMs, 5 had type II, 6 had type III and 3 had type IV VMs. One patient had type I and type III VMs in different locations of the maxillofacial region. For types I and II lesions, pingyangmycin sclerotherapy was performed. Multistage sclerotherapy with absolute ethanol and pingyangmycin was performed on types III and IV lesions.


RESULTS
After evaluation and guided by preoperative digital subtraction angiography, all the patients were treated successfully and safely. Of the 20 patients, the clinical outcome was excellent in 13, good in 6, and fair in 1. No disease recurrence was noted during the follow-up evaluations (range 6 to 25 months, median 13.55). The complications were fever in 5 patients after the first session of sclerotherapy, incomplete facial paralysis in 1, swelling in 1, and ulceration in 3. No major complications were observed.


CONCLUSIONS
Digital subtraction angiography-guided phlebography of VMs in the maxillofacial region is one of the approaches to classify VMs using anatomic and hemodynamic features. A strong association was seen between the type of VM and the approach of sclerotherapy. Percutaneous sclerotherapy using pingyangmycin and/or absolute ethanol is a safe and effective method of treating symptomatic VMs.
Li
Jiapeng
J
Centre of Stomatology, First Hospital of Foshan, Foshan, China.
Chen
Jufeng
J
Zheng
Guangsen
G
Liao
Guiqing
G
Fu
Zhifeng
Z
Li
Jin
J
Zhang
Tonghan
T
Su
Yuxiong
Y
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D000431:Ethanol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005145:Face / Q000098:blood supply; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D007223:Infant; D008297:Male; D008410:Masticatory Muscles / Q000098:blood supply; D008875:Middle Aged; D009333:Neck / Q000098:blood supply; D019226:Oral Ulcer / Q000139:chemically induced; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods*; D054079:Vascular Malformations / Q000145:classification* / Q000628:therapy*; D014680:Veins / Q000002:abnormalities*; D055815:Young Adult
D012597:Sclerosing Solutions; D001761:Bleomycin; D000431:Ethanol; C025703:bleomycetin