title: Bleomycin Foam Treatment of Venous Malformations: A Promising Agent for Effective Treatment with Minimal Swelling.
abstract: OBJECTIVE
  To report clinical and radiographic outcomes of patients with venous malformations (VMs) treated with bleomycin foam.
  
  
  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.affiliation: 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.
authors.forename: Faheem
authors.initials: F
authors.lastname: Ul Haq
authors.affiliation: 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.
authors.forename: Sally E
authors.initials: SE
authors.lastname: Mitchell
authors.affiliation: 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.
authors.forename: Aylin
authors.initials: A
authors.lastname: Tekes
authors.affiliation: 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.
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D001761:Bleomycin / Q000008:administration & dosage* / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004487:Edema / Q000139:chemically induced / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000188:drug therapy*; D014680:Veins / Q000002:abnormalities* / Q000187:drug effects*; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions; D001761:Bleomycin