Percutaneous treatment of facial venous malformations: A matched comparison of alcohol and bleomycin sclerotherapy

BACKGROUND: Venous malformations (VMs) are common vascular anomalies; 40% are found in the head and neck. Percutaneous sclerotherapy is 1 treatment of choice. METHODS: In all, 17 patients with facial VMs were treated by percutaneous sclerotherapy using alcohol and individually matched to lesions treated with bleomycin. Treatment details and outcomes were compared. The average numbers of sessions were 1.7 for alcohol and 3.4 for bleomycin. Average dose administered was 8.1 cm³ alcohol and 9.1 units bleomycin. RESULTS: Of those treated with alcohol, 2 developed adverse effects and 7 developed complications. None treated with bleomycin developed adverse effects or complications. All patients treated with alcohol improved clinically. In all, 15 patients treated with bleomycin improved after treatment and 2 were unchanged. CONCLUSIONS: Alcohol has a slightly higher success rate and requires fewer treatment sessions. Bleomycin has a lower complication rate and less postprocedural swelling. Bleomycin treatment may be better tolerated and is thus preferred over alcohol sclerotherapy.