Efficacy and Safety of Hyaluronic-polidocanol Foam in Sclerotherapy for Head and Neck Venous Malformations

Overview

Journal Front Neurol

Specialty Neurology

Date 2024 Sep 2

PMID 39220735

Authors

Zhaoyang Sun

Yiran Liu

Anwei Chen

Tao Wang

Shaohua Liu

Affiliations

Soon will be listed here.

Abstract

Background: Foam sclerotherapy is currently the first-line treatment for venous malformations (VMs). Hyaluronic acid-polidocanol (HA-POL) foam has been used in the treatment of head and neck VMs recently; however, its clinical efficacy and safety have yet to be further evaluated, and the impact of age and other related factors on its safety is still unclear.

Objective: To assess the efficacy and safety of HA-POL foam in the treatment of head and neck VMs.

Methods And Materials: We performed a single-center retrospective review of all patients with VMs involving the head and neck region undergoing HA-POL foam sclerotherapy from February 2015 to February 2022 in the Oral and Maxillofacial Surgery Department of Qilu Hospital Shandong University. Patients' medical records were collected and all patients enrolled were followed up for 1-6 months (group 1), part of them were followed up for 3-9 years (group 2).

Results: A total of 223 patients with head and neck VMs were enrolled in the study, with 36 patients who were followed for 3-9 years. Total response rate in group 1 was 96.41% ( = 215), of which 30.94% ( = 69) of the patients met the criteria of "resolution," and 65.47% ( = 146) of the patients had "significant improvement." In group 2, the total response rate was 72.22% ( = 26), of which the rates of the patients met the criteria of "resolution" and patients had "significant improvement" were all 36.11% ( = 13)0.144 (64.57%) patients experienced complications like localized swelling, pain and fever, and no serious complications occurred. The risk of developing complications after treatment was independent of age, and was weakly associated with the dose of HA-POL foam.

Conclusion: The HA-POL foam sclerotherapy is safe and effective in the treatment of head and neck VMs.

References

Chen A, Liu Y, Li K, Liu S . An Investigation on the Influence of Hyaluronic Acid on Polidocanol Foam Stability. Dermatol Surg. 2015; 42(1):56-8. DOI: 10.1097/DSS.0000000000000595. View

Chen A, Liu S, Huang Y, Wang T . Preliminary Experience With More Stable Polidocanol Foam in Sclerotherapy of Head and Neck Venous Malformations. Dermatol Surg. 2018; 44(11):1421-1426. DOI: 10.1097/DSS.0000000000001587. View

Markovic J, Nag U, Shortell C . Safety and efficacy of foam sclerotherapy for treatment of low-flow vascular malformations in children. J Vasc Surg Venous Lymphat Disord. 2020; 8(6):1074-1082. DOI: 10.1016/j.jvsv.2019.11.023. View

Ziyi L, Xuanxuan S, Dongjian L, Azmoun S, Shaohua L . The role of hyaluronic acid in polidocanol foam: An in vitro study. Phlebology. 2022; 37(10):701-708. DOI: 10.1177/02683555221129555. View

Yao M, Ma J, Wu D, Fang C, Wang Z, Guo T . Neutrophil extracellular traps mediate deep vein thrombosis: from mechanism to therapy. Front Immunol. 2023; 14:1198952. PMC: 10482110. DOI: 10.3389/fimmu.2023.1198952. View

Schmidt V, Masthoff M, Brill R, Sporns P, Kohler M, Schulze-Zachau V . Image-Guided Embolotherapy of Arteriovenous Malformations of the Face. Cardiovasc Intervent Radiol. 2022; 45(7):992-1000. PMC: 9226106. DOI: 10.1007/s00270-022-03169-0. View

Del Castillo-Santaella T, Yang Y, Martinez-Gonzalez I, Galvez-Ruiz M, Cabrerizo-Vilchez M, Holgado-Terriza J . Effect of Hyaluronic Acid and Pluronic-F68 on the Surface Properties of Foam as a Delivery System for Polidocanol in Sclerotherapy. Pharmaceutics. 2020; 12(11). PMC: 7693533. DOI: 10.3390/pharmaceutics12111039. View

Peterson J, Goldman M . An investigation on the influence of glycerin on sclerosant foam stability. Phlebology. 2011; 26(6):232-4. DOI: 10.1258/phleb.2010.010028. View

Mooijaart S, Broekhuizen K, Trompet S, de Craen A, Gussekloo J, Oleksik A . Evidence-based medicine in older patients: how can we do better?. Neth J Med. 2015; 73(5):211-8. View

10.

Noah B . Just a spoonful of sugar: drug safety for pediatric populations. J Law Med Ethics. 2009; 37(2):280-91. DOI: 10.1111/j.1748-720X.2009.00372.x. View

11.

Burdick J, Prestwich G . Hyaluronic acid hydrogels for biomedical applications. Adv Mater. 2011; 23(12):H41-56. PMC: 3730855. DOI: 10.1002/adma.201003963. View

12.

Fakhari A, Berkland C . Applications and emerging trends of hyaluronic acid in tissue engineering, as a dermal filler and in osteoarthritis treatment. Acta Biomater. 2013; 9(7):7081-92. PMC: 3669638. DOI: 10.1016/j.actbio.2013.03.005. View

13.

Iannitti T, Rottigni V, Torricelli F, Palmieri B . Combination therapy of hyaluronic acid mesotherapic injections and sclerotherapy for treatment of lower leg telangiectasia without major venous insufficiency: a preliminary clinical study. Clin Appl Thromb Hemost. 2012; 20(3):326-30. DOI: 10.1177/1076029612461844. View

14.

Contopoulos-Ioannidis D, Baltogianni M, Ioannidis J . Comparative effectiveness of medical interventions in adults versus children. J Pediatr. 2010; 157(2):322-330.e17. DOI: 10.1016/j.jpeds.2010.02.011. View

15.

Fraser J, Laurent T, Engstrom-Laurent A, Laurent U . Elimination of hyaluronic acid from the blood stream in the human. Clin Exp Pharmacol Physiol. 1984; 11(1):17-25. DOI: 10.1111/j.1440-1681.1984.tb00235.x. View

16.

Bailey C, Herrera D, Neumeister N, Weiss C . Magnetic resonance - guided treatment of low-flow vascular malformations and the technologies to potentiate adoption. Front Med (Lausanne). 2024; 11:1319046. PMC: 10899448. DOI: 10.3389/fmed.2024.1319046. View

17.

Valenzuela G, Wong K, Connor D, Behnia M, Parsi K . Foam sclerosants are more stable at lower temperatures. Eur J Vasc Endovasc Surg. 2013; 46(5):593-9. DOI: 10.1016/j.ejvs.2013.08.012. View

18.

Li L, Feng J, Zeng X, Li Y . Fluoroscopy-guided foam sclerotherapy with sodium morrhuate for peripheral venous malformations: Preliminary experience. J Vasc Surg. 2009; 49(4):961-7. DOI: 10.1016/j.jvs.2008.10.037. View

19.

Bai T, Liu Y, Liu J, Yu C, Jiang W, Fan Y . A comparison of different surfactants on foam stability in foam sclerotherapy in vitro. J Vasc Surg. 2018; 69(2):581-591.e1. DOI: 10.1016/j.jvs.2018.02.033. View

20.

Alsuwailem A, Myer 4th C, Chaudry G . Vascular anomalies of the head and neck. Semin Pediatr Surg. 2020; 29(5):150968. DOI: 10.1016/j.sempedsurg.2020.150968. View