Research trends and hotspots in sclerotherapy for vascular malformations: bibliometric and visual analyses

Vascular malformations are a group of congenital vascular developmental anomalies. According to the International Society for the Study of Vascular Anomalies classification, they are mainly divided into Slow-Flow and Fast-Flow lesions. Slow-Flow lesions are represented by venous malformations, lymphatic malformations, and capillary malformations; Fast-Flow lesions primarily include arteriovenous malformations and arteriovenous fistulae. As a minimally invasive interventional approach, sclerotherapy has become a first-line treatment for Slow-Flow vascular malformations; significant advances in techniques, agents, and combination therapies have been made in recent years. However, a systematic bibliometric analysis of overall research trends, knowledge structure, and frontier hotspots in this field is lacking.

Using the Web of Science Core Collection and PubMed databases, we retrieved literature on sclerotherapy for vascular malformations from 2005 to 2025, including 2,040 and 1,855 articles, respectively. VOSviewer, CiteSpace and Bibliometrix were employed to analyze publication trends, collaboration networks, journal distribution, highly cited literature, keyword clustering, and burst detection. Cross-validation across the two databases was performed to enhance robustness.

Annual publications accelerated from 2015 and showed an explosive increase after 2020. China, the United States, and Japan were the top three publishing countries, with 535, 451, and 106 publications, respectively; the United States led in total citations. Shanghai Jiao Tong University, Shandong University, and Sungkyunkwan University were the most active institutions. Journal distribution followed Bradford's law, with Zone 1 comprising 30 journals. Three-field (three-map) analysis revealed that core authors such as Lee BB and Do YS formed dense networks with key terms and journals. LDA topic modeling identified 15 topics; evolutionary analysis indicated a field shift from traditional sclerosants toward targeted therapies, electrochemical treatments, and artificial intelligence. Burst-term analysis confirmed sirolimus and intralesional bleomycin as sustained frontiers. PubMed and WoS results were highly consistent.

This study provides the first systematic 20-year knowledge map of the field of sclerotherapy for vascular malformations. China is the most productive country, though average per-article impact remains to be improved. The field is transitioning toward targeted therapies, physicochemical synergistic approaches, and multidisciplinary comprehensive management. Future work should strengthen combined targeted-drug and sclerotherapy approaches, promote AI-assisted precision treatment, and conduct high-quality prospective clinical studies.