Intralesional injection of bleomycin in the management of low flow vascular malformations: Results and factors affecting the outcome

Efficacy of sclerotherapy with pingyangmycin and polidocanol for venous malformations

Objective

To investigate the treatment outcomes of sclerotherapy with pingyangmycin and polidocanol for venous malformations.

Methods

This retrospective study included patients with venous malformations who underwent sclerotherapy between January 2022 and June 2024. Patient demographics, symptoms, treatment information were gathered from the electronic medical records, and imaging data from the hospital's picture archiving and communication system were reviewed.

Results

A total of 29 patients, composed of 12 males and 17 females, with venous malformations, who underwent 66 procedures during the study period, were analyzed. The lesions were located in the lower limbs in 13 cases, in the upper limbs in 9, in the head and neck in 5, and in the trunk in 2. Twenty-four patients presented with pain, with a median visual analog scale (VAS) score of 4 and the correlation with age was statistically significant. After sclerotherapy, the median VAS score declined to 1, and there was a statistical difference in the overall median VAS score between pre- and post-treatment. According to the evaluation criteria, the treatment response was evaluated as grade 4 in 4 cases, as grade 3 in 17 cases, and as grade 2 in 8 cases; none of the treatment responses was evaluated as grade 1. None of the patients experienced serious adverse reactions.

Conclusion

Sclerotherapy with pingyangmycin and polidocanol is a treatment modality for relieving the clinical symptoms of venous malformations, with good efficacy and few potential risks.

Microneedle delivery system with rapid dissolution and sustained release of bleomycin for the treatment of hemangiomas

Hemangioma of infancy is the most common vascular tumor during infancy and childhood. Despite the proven efficacy of propranolol treatment, certain patients still encounter resistance or face recurrence. The need for frequent daily medication also poses challenges to patient adherence. Bleomycin (BLM) has demonstrated effectiveness against vascular anomalies, yet its use is limited by dose-related complications. Addressing this, this study proposes a novel approach for treating hemangiomas using BLM-loaded hyaluronic acid (HA)-based microneedle (MN) patches. BLM is encapsulated during the synthesis of polylactic acid (PLA) microspheres (MPs). The successful preparation of PLA MPs and MN patches is confirmed through scanning electron microscopy (SEM) images. The HA microneedles dissolve rapidly upon skin insertion, releasing BLM@PLA MPs. These MPs gradually degrade within 28 days, providing a sustained release of BLM. Comprehensive safety assessments, including cell viability, hemolysis ratio, and intradermal reactions in rabbits, validate the safety of MN patches. The BLM@PLA-MNs exhibit an effective inhibitory efficiency against hemangioma formation in a murine hemangioma model. Of significant importance, RNA-seq analysis reveals that BLM@PLA-MNs exert their inhibitory effect on hemangiomas by regulating the P53 pathway. In summary, BLM@PLA-MNs emerge as a promising clinical candidate for the effective treatment of hemangiomas.