Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jun 21;57(2):141-149.
doi: 10.2478/raon-2023-0029. eCollection 2023 Jun 1.

Bleomycin electrosclerotherapy (BEST) for the treatment of vascular malformations. An International Network for Sharing Practices on Electrochemotherapy (InspECT) study group report

Tobian Muir  1 , Giulia Bertino  2 , Ales Groselj  3   4 , Lakshmi Ratnam  5 , Erika Kis  6 , Joy Odili  7 , Ian McCafferty  8 , Walter A Wohlgemuth  9 , Maja Cemazar  10   11 , Aljosa Krt  12 , Masa Bosnjak  10 , Alessandro Zanasi  13 , Michela Battista  13 , Francesca de Terlizzi  13 , Luca G Campana  14 , Gregor Sersa  10   15
Affiliations
Review

Bleomycin electrosclerotherapy (BEST) for the treatment of vascular malformations. An International Network for Sharing Practices on Electrochemotherapy (InspECT) study group report

Tobian Muir et al. Radiol Oncol. .

Abstract

Background: Biomedical applications of electroporation are expanding out of the field of oncology into vaccination, treatment of arrhythmias and now in the treatment of vascular malformations. Bleomycin is a widely used sclerosing agent in the treatment of various vascular malformations. The application of electric pulses in addition to bleomycin enhances the effectiveness of the drug, as demonstrated by electrochemotherapy, which utilizes bleomycin in the treatment of tumors. The same principle is used in bleomycin electrosclerotherapy (BEST). The approach seems to be effective in the treatment of low-flow (venous and lymphatic) and, potentially, even high-flow (arteriovenous) malformations. Although there are only a few published reports to date, the surgical community is interested, and an increasing number of centers are applying BEST in the treatment of vascular malformations. Within the International Network for Sharing Practices on Electrochemotherapy (InspECT) consortium, a dedicated working group has been constituted to develop standard operating procedures for BEST and foster clinical trials.

Conclusions: By treatment standardization and successful completion of clinical trials demonstrating the effectiveness and safety of the approach, higher quality data and better clinical outcomes may be achieved.

Keywords: bleomycin; bleomycin electrosclerotherapy; electrochemotherapy; vascular malformations.

PubMed Disclaimer

Figures

FIGURE 1.
FIGURE 1.
Treatment of vascularized melanoma metastasis by electrochemotherapy. (A) Highly vascularized tumor before treatment. (B) Bleeding due to electrode insertion after application of electric pulses to the tumor. (C) Bleeding stopped immediately after electric pulse application.
FIGURE 2.
FIGURE 2.
Patient treated by BEST. Axial T2-weighted, fat-saturated MRI with hyperintense (arrow) gluteal venous malformation before treatment (A). Axial T2-weighted, fat-saturated MRI of the same region 4 months after treatment. The main part of the venous malformation is occluded (B). Photography before (C) and after the treatment (D).
See this image and copyright information in PMC

References

    1. Classification International Society for the Study of Vascular Anomalies. [Internet] [cited 2023 May 16]. Available at: https://www.issva.org/classification .
    1. Wu IC, Orbach DB. Neurointerventional management of high-flow vascular malformations of the head and neck. Neuroimaging Clin N Am. 2009;19:219–40. doi: 10.1016/j.nic.2009.01.005. - DOI - PubMed
    1. Sadick M, Wohlgemuth WA, Huelse R, Lange B, Henzler T, Schoenberg SO. et al. Interdisciplinary management of head and neck vascular anomalies: clinical presentation, diagnostic findings and minimalinvasive therapies. Eur J Radiol Open. 2017;4:63–8. doi: 10.1016/j.ejro.2017.05.001. - DOI - PMC - PubMed
    1. Hage AN, Beecham Chick JF, Srinivasa RN, Bundy JJ, Chauhan NR, Acord M. et al. Treatment of venous malformations: the data, where we are, and how it is done. Tech Vasc Interv Radiol. 2018;21:45–54. doi: 10.1053/j.tvir.2018.03.001. - DOI - PubMed
    1. Horbach SER, Lokhorst MM, Saeed P, de Goüyon Matignon de Pontouraude CMF, Rothová A, Van Der Horst CMAM. Sclerotherapy for low-flow vascular malformations of the head and neck: a systematic review of sclerosing agents. J Plast Reconstr Aesthet Surg. 2016;69:295–304. doi: 10.1016/j.bjps.2015.10.045. - DOI - PubMed

Publication types

LinkOut - more resources