Intralesional radiofrequency in venous malformations

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Dermatology

Background:

• Venous malformations (VMs) are typically asymptomatic and managed conservatively.
• Treatment for symptomatic or cosmetically concerning VMs includes laser, sclerotherapy, or resection.
• Bleomycin injections are a common intralesional treatment for VMs.

Purpose of the Study:

• To evaluate the efficacy of radiofrequency ablation (RFA) as an adjunct therapy for VMs.
• To assess RFA in patients with incomplete resolution after intralesional bleomycin treatment.
• To determine functional and cosmetic outcomes of combined RFA and bleomycin therapy.

Main Methods:

• A prospective clinical study involving five patients with head and neck VMs.
• Patients received 8 intralesional bleomycin injections (0.5U/kg) every 2 weeks.
• Subsequent intralesional radiofrequency ablation was performed every 2 months until satisfactory results.

Main Results:

• Initial bleomycin injections resulted in less than 50% size reduction of VMs.
• 2-4 RFA applications led to approximately 80% reduction in lesion size.
• Good functional and cosmetic outcomes were achieved post-treatment.

Conclusions:

• Radiofrequency ablation is an effective adjunctive treatment for head and neck venous malformations.
• The combination of RFA and bleomycin offers a viable option for recalcitrant VMs.
• This combined approach has not been previously described for VM treatment.