polidocanol and Hemangioma

A meta-analysis was conducted to investigate the efficacy and safety of polidocanol versus other conventional therapies in treating hemangiomas (HMs) and vascular malformations (VMs). Literature search was conducted in the Cochrane, Embase, PubMed, Web of Science, CNKI, CBM, VIP, and WanFang databases until March 5, 2017. A meta-analysis was conducted using Revman 5.3 software. A total of 19 randomized controlled trials (RCTs) involving 1,514 participants met the inclusion criteria. Regarding the effectiveness, statistically significant differences were observed between polidocanol and all the independent treatments (p = .006), but not between polidocanol and pingyangmycin (p = .16). Combination therapy of polidocanol with any other conventional treatments (p = .0001), pingyangmycin (p = .005) or hemoclip (p = .008) elicited a better response compared to treatment with these treatments independently. A meta-analysis on the risk of adverse events (AEs) showed a lower risk for polidocanol versus other treatments, for example, all the conventional treatments used independently (p < .00001) and pingyangmycin (p < .00001). Combination therapy of polidocanol with pingyangmycin also yielded a significantly lower risk of AEs (p < .00001). Polidocanol is at least as effective as other conventional therapies on HMs and VMs (especially venous malformations). The former is much safer. Combining its use with other treatments may produce excellent results. Our study provides strong evidence supporting the use of polidocanol for HMs and VMs.

Topics: Adolescent; Adult; Aged; Antibiotics, Antineoplastic; Bleomycin; Chi-Square Distribution; Child; Child, Preschool; Female; Hemangioma; Humans; Infant; Infant, Newborn; Male; Middle Aged; Odds Ratio; Polidocanol; Polyethylene Glycols; Randomized Controlled Trials as Topic; Risk Factors; Sclerosing Solutions; Sclerotherapy; Treatment Outcome; Vascular Malformations; Young Adult

Sclerotherapy has achieved great success in treating most venous malformation (VM) lesions.. To compare the effects of foam sclerotherapy on infantile hemangioma and pyogenic granuloma (PG). In addition, we analyzed the data and outcomes of foam sclerotherapy for the VM.. Thirty-nine patients with hemangiomas and 83 patients with VMs were treated, and clinical outcomes, resolution, and complication rates were compared. Sclerotherapy data from the VM group were also analyzed.. The average age of the patients and the distribution and tissue involvement of lesions among the 3 groups were significantly different ( p < .001). The average amount of sclerosing foam administered per session in VMs was significantly higher than that in the other 2 groups ( p < .0001) (whereas that in the PG group was lower than that in the infantile hemangioma group [ p < .0001]). However, the overall therapeutic efficacy and side effects in the 3 groups were not significantly different. For VMs, the frequency of ultrasound guided foam sclerotherapy and use of 3% polidocanol increased from superficial to deep lesions, whereas the use of 1% POL decreased ( p < .0001).. Infantile hemangioma and PG treatments presented good results and minor adverse reactions comparable with those of VMs.

Topics: Hemangioma; Hemangioma, Capillary; Humans; Polidocanol; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Treatment Outcome; Vascular Malformations

Topics: Adult; Aged; Endoscopy; Female; Hemangioma; Humans; Hypopharyngeal Neoplasms; Injections; Male; Middle Aged; Polidocanol; Sclerosing Solutions; Sclerotherapy

Small-bowel hemangiomas are a possible source of gastrointestinal bleeding for which there is no established treatment approach. In this report, we describe the case of a 58-year-old woman who presented with hematochezia and who was diagnosed with small bowel hemangioma. She was successfully treated using endoscopic sclerotherapy. Initial capsule endoscopy revealed bleeding in the ileum. Subsequent double-balloon enteroscopy showed a 2-cm, bluish-purple, ileal submucosal tumor with an overlying protrusion. The lesion was responsible for the hematochezia and was treated with intralesional injection of polidocanol. The hematochezia completely resolved and at 4 months after sclerotherapy, the size of the lesion was significantly reduced.

Topics: Double-Balloon Enteroscopy; Female; Hemangioma; Humans; Ileal Neoplasms; Middle Aged; Polidocanol; Sclerosing Solutions; Sclerotherapy; Treatment Outcome

Infantile hemangiomas (IH) are at risk of incomplete regression with remnant permanent sequelae, ranging from passive waiting for spontaneous regression to active systemic administration. The application of traditional therapy involving injection of a sclerosing agent is limited due to the difficulty in achieving cosmetic improvement. This study aimed to explore a new injection method that could not only promote tumor regression but also achieve cosmetic improvement. A total of 122 IH (from 109 children) injected intralesionally with lauromacrogol in the Plastic Surgery Department of Fujian Medical University Union Hospital between 1 January 2012 and 1 June 2019 were enrolled in this study. The mean follow-up time was 2.9 years. Of 122 lesions studied, 111 (91.0%) achieved complete regression, 10 (8.2%) achieved significant regression and one (0.8%) achieved moderate regression. In terms of aesthetic appearance, 70 (57.4%) IH had no sequelae and the A score was 5/5. Twenty-one (17.2%) IH had minimal hyperpigmentation, hypopigmentation or telangiectasia and the A score was 4/5. Thirty-one (25.4%) IH had left mild or relatively obvious sequelae and the A score was 1-3/5. None of the 122 IH involved had rebound growth after terminating the treatment. Hyper- or hypopigmentation gradually faded over time and part of the IH had already returned to normal appearance by the time of long-term follow up. The results indicated that this new type of injection therapy significantly promoted the regression of uncomplicated IH and helped achieve the expected cosmetic appearance.

Topics: Child; Esthetics; Follow-Up Studies; Hemangioma; Humans; Infant; Injections, Intralesional; Polidocanol; Retrospective Studies; Skin Neoplasms; Treatment Outcome

The efficacy of lauromacrogol injection therapy and intralesional triamcinolone for infantile hemangiomas (IH) has been well documented recently, but with an increase in serious or rare adverse reactions. The aim of this study is to investigate the safety concerns regarding intralesional injection of lauromacrogol combined with triamcinolone for IH and to study its effect on infant growth and development. A total of 1039 IH patients who were subjected to intralesional injection of lauromacrogol combined with triamcinolone in the Plastic Surgery Department of Shandong Provincial Hospital between 1 January 2015 and 31 May 2018 were enrolled in this study. When the dose of lauromacrogol and triamcinolone was less than 3.5 and 2.0 mg/kg respectively, no serious side-effects were observed. The adverse event rate reported was 7.7%. Among the 405 patients not subjected to propranolol before the last injection, the study included three modes of treatment response: regression (82.7%), stabilization (13.8%) and failure (3.5%). By comparing height and weight to the reference standards and also by comparisons between the same-sex groups, our results confirmed that there was no significant effect on children's height and weight, regardless of whether the injection therapy was combined with oral propranolol at the appropriate dose and with more than 4-week intervals. Intralesional injection of lauromacrogol combined with triamcinolone in the treatment of IH was highly safe and effective.

Topics: Adrenergic beta-Antagonists; Body Height; Body Weight; Child Development; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Follow-Up Studies; Glucocorticoids; Hemangioma; Humans; Infant; Injections, Intralesional; Male; Polidocanol; Propranolol; Retrospective Studies; Sclerosing Solutions; Treatment Outcome; Triamcinolone

To investigate the clinical effect of radiofrequency ablation (RFA) combined with lauromacrogol for the treatment of parotid gland hemangioma in infants.. From Sep.2005 to Dec.2014,a total of 117 patients with parotid gland hemangioma were divided into observation group (n =32),control group 1 (n =30),control group 2 (n =28) and control group 3 (n =27).The observation group was treated by RFA combined with lauromacrogol, while the control group 1 was treated by RFA only, the control group 2 was treated by pingyangmycin only, and the control group 3 received additional pingyangmycin based on RFA. All the patients were followed up for 6 to 24 months, and the clinical effects were observed in four groups.. Control group 1:16 patients were cured (53.3％),and the number of patients with ≥2 treatments was 9.There was 1 case with skin ulceration,1 with abdominal discomfort,1 with liver function damage and 1 with high fever.Control group 2:17 patients were cured(60.7％),and number of patients with ≥2 treatments was 12.There were 3 cases with skin ulceration,9 with abdominal discomfort,6 with liver function damage and 5 with high fever.Control group 3:21 patients were cured(77.8％),and number of patients with ≥2 treatments was 2.There were 2 cases with skin ulceration,6 with abdominal discomfort,4 with liver function damage and 4 with high fever.However,in observation group,25 patients were cured(78.1％) and number of patients with ≥ 2 treatments was 4,which were significantly different from that in control group 1 or control group 2 (P ＜0.05).And the difference in postoperative adverse reactions between observation group and control group 2 or control group 3 was also of significance (2 with skin ulceration,1 with abdominal discomfort,1 with liver function damage and 6 with high fever,P ＜ 0.05).. Combined RFA and lauromacrogol has a good therapeutic effect on parotid gland hemangioma with relatively low adverse effect, so it deserves to be suggested and applied in clinical practice.

Topics: Antibiotics, Antineoplastic; Bleomycin; Catheter Ablation; Female; Hemangioma; Humans; Infant; Male; Parotid Gland; Polidocanol; Polyethylene Glycols; Treatment Outcome

Small-bowel hemangioma is a rare disease that often causes active bleeding. The standard therapeutic method for small-bowel hemangioma is surgical resection. The aim of this study was to evaluate the usefulness of polidocanol injection (PDI) for small-bowel hemangiomas.. This study included 12 patients with obscure GI bleeding (6 male; mean age 62 years) with 39 small-bowel hemangiomas; patients were treated with PDI by using double-balloon endoscopy (DBE). EUS with DBE was performed before PDI. The lesions were divided into 2 groups according to tumor size: Group A (size <10 mm; 20 lesions) and group B (size ≥10 mm; 19 lesions). The outcomes of PDI treatment for small-bowel hemangioma were evaluated between the 2 groups. Additionally, in order to standardize the amount of PDI injected, the total amount of polidocanol according to lesion size was calculated.. There was no difference in the location of lesions and treatment times between the 2 groups. Group B had a significantly higher injection time per lesion (P < .05) and amount of polidocanol per lesion than group A (P < .01). Rebleeding occurred in only 1 case (8%). There were no adverse events related to PDI. The contribution ratio between the lesion size and amount of polidocanol showed a correlation (r = 0.77). The optimal amount of polidocanol for small-bowel hemangioma was determined to be 0.2 mL/mm.. PDI is an easy, safe, and effective method to treat small-bowel hemangiomas.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Double-Balloon Enteroscopy; Female; Gastrointestinal Hemorrhage; Hemangioma; Humans; Ileal Neoplasms; Injections, Intralesional; Jejunal Neoplasms; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Retrospective Studies; Sclerosing Solutions; Young Adult

Hemangiomas (proliferating endothelial tumors) are the most common benign tumors of infancy. Most often hemangiomas are self-regressing lesions without any treatment. Approximately 10% of hemangiomas cause complications such as major ulceration/destruction, distortion of involved tissues, and obstruction of a vital structure. When the situation becomes complicated, there are different treatment alternatives, ranging from systemic or local corticosteroid use to surgery. Sclerotherapy using intralesional polidocanol (Aethoxysklerol) injection may be used before surgery to decrease blood loss or when a vital structure of the face is in danger because of sudden increase in size of a surrounding hemangioma. Before any kind of treatment for both hemangiomas and vascular malformations, preoperative diagnosis and anatomic position of the lesion must be documented thoroughly. With the help of magnetic resonance imaging, tridimensional vascular pattern of such lesions can be shown successfully. We used three-dimensional contrast-enhanced time-resolved magnetic resonance angiography to detect the changes of lesions for 2 children who have large hemangiomas on their faces, before and after sclerotherapy with polidocanol injection. The findings of three-dimensional magnetic resonance imaging studies help to better assess the success rate of treatment not only for us as the physicians but also for the parents of these children who cannot understand anything with standard two-dimensional radiologic imaging.

Topics: Child, Preschool; Contrast Media; Female; Gadolinium DTPA; Head and Neck Neoplasms; Hemangioma; Humans; Imaging, Three-Dimensional; Magnetic Resonance Angiography; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Suture Techniques

While sclerotherapy in chronic venous insufficiency and in hemorrhoids is well established, the use of sclerotherapy for hemangiomas of the skin is widely unknown.. The aim of the study was to analyze the clinical value of sclerotherapy with polidocanol in a larger population.. Over a period of 20 years (1975-1995) we performed sclerotherapy of hemangiomas and vascular malformations in a total of 157 patients. Their ages ranged from 3 months to 75 years. Among these were 87 (55.4%) children and adolescents (up to the age of 18). Sclerotherapy with polidocanol was carried out mostly at monstrous or rapidly growing cavernous hemangiomas mainly localized in the face.. One to three injections was usually sufficient to obtain the sclerosis effect; aesthetically, long-term results were convincing. Severe complications were not observed.. Sclerotherapy of hemangiomas is a relatively simple, effective, and inexpensive method that is a valuable and promising treatment.

Topics: Adolescent; Adult; Child; Female; Follow-Up Studies; Hemangioma; Humans; Infant; Male; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Skin Neoplasms; Treatment Outcome

The treatment of hemangiomas and vascular malformations in the soft tissue presents several difficult problems. Transarterial embolization and/or percutaneous sclerosing therapy are useful for such lesions, but the effectiveness of these therapies is often partial, and serious problems like ulceration and tissue necrosis may occur. Therefore, we examined the efficacy of intraarterial injection of polidocanol solution as an embolic agent for hemangiomas and vascular malformations using the rabbit kidney. Three embolic agents were compared with polidocanol solution (polidocanol 3%, n = 5; absolute ethanol, n = 5; n-butyl-2 cyanoacrylate: NBCA, n = 5; polyvinyl alcohol: PVA, n = 5). All embolizations were followed by angiography and resection after a week. Results showed that absolute ethanol (n = 5), NBCA (n = 4) and PVA (n = 1) embolized completely. In the specimens, this led to cell necrosis throughout the kidney. In contrast, polidocanol (n = 5) obstructed neither the main trunk of the renal artery nor the peripheral capillary arteries following angiography. In the specimens, the inner medulla of the kidney suffered necrosis. However, residual tissue with massive fibrotic change was seen. These results suggest the efficacy of "embolosclerosing" treatment for capillary vascular lesions and the possibility of alleviating complications from such therapy.

Topics: Animals; Disease Models, Animal; Embolization, Therapeutic; Hemangioma; Injections, Intra-Arterial; Kidney Neoplasms; Polidocanol; Polyethylene Glycols; Rabbits; Renal Artery; Sclerosing Solutions

A cutaneous hemangioma of the penis extending from the proximal portion of the glans to the prepuce of an 18-year-old man was successfully treated by sclerotherapy with polidocanol and interrupted ligation of the hemangioma.

Topics: Adolescent; Hemangioma; Humans; Ligation; Male; Necrosis; Penile Neoplasms; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Skin

The authors discuss the indications for hydroxypolyethoxydodecan in the sclerosing treatment of angiomas, with particular reference to cavernous, venous, and evolutive angiomas (ie, immature angiomas that fail to involute by eight to ten months). Moreover, the sclerosing agent may be employed, in connection with embolization and subsequent surgery, in arteriovenous angiomas with a relevant cutaneous-subcutaneous development. The authors have successfully used the "interstitial" sclerosing technique, according to Andrews' method. This technique involves interstitial injections to obtain the sclerosis of the thin threads of fibrous tissue stroma between the blood vessels. The sclerosing therapy may cause the complete regression of "low flow" angiomas or, at least, a partial reduction that simplifies the ensuing surgical excision. In the case of partial regression of the angioma obtained with the sclerosing therapy, the surgery of the remaining angioma causes a lesser degree of bleeding (especially in areas that do not particularly lend themselves to surgical exploration, ie, the oral cavity); an increased reliability in the radicality of the intervention (due also to the reduced size of the lesion); and better results from an aesthetic-functional point of view.

Topics: Adolescent; Adult; Child; Extremities; Facial Neoplasms; Female; Hemangioma; Humans; Male; Middle Aged; Mouth Neoplasms; Polidocanol; Polyethylene Glycols; Sclerotherapy

We report a case of sudoriparous angioma on the dorsum and plantar aspect of the left foot which increased in size on standing, and which was accompanied by sweating in the overlying epidermis and throbbing pain. The lesion regressed considerably following intravascular injection of 1% aethoxysclerol.

Topics: Child; Female; Foot Diseases; Hemangioma; Humans; Phlebography; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Skin Neoplasms; Sweating

Topics: Adolescent; Adult; Aged; Facial Neoplasms; Female; Hemangioma; Humans; Male; Middle Aged; Mouth Neoplasms; Polidocanol; Polyethylene Glycols; Sclerosing Solutions