Bevacizumab and interferon reduce venous recanalization following sclerotherapy

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• 作者：Ann M. Kulungowski^a ; ^c ; Aladdin H. Hassanein^b ; ^c ; ^{ahhassanein@partners.org" class="auth_mail" title="E-mail the corresponding author} ; Carolyn C. Foster^b ; ^c ; Arin K. Greene^b ; ^c ; Steven J. Fishman^a ; ^c ; ^{steven.fishman@childrens.harvard.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Recurrence ; Sclerotherapy ; Vascular anomaly ; Venous malformation
• 刊名：Journal of Pediatric Surgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：51
• 期：10
• 页码：1670-1673
• 全文大小：497 K

文摘

The treatment of venous malformations is difficult because these lesions frequently recur after resection or sclerotherapy. The purpose of this study was to determine whether recanalization of sclerosed venous lumens could be prevented with systemic angiogenic inhibition using bevacizumab or peginterferon alfa-2a.

Methods

To establish an animal model of recanalization of sclerosed facial veins, 18 rabbits had ethanol sclerotherapy of 1 facial vein followed by venography after 4 weeks (n = 6), 12 weeks (n = 6), and 24 weeks (n = 6). Subsequently, 21 different leporids underwent sclerotherapy of both facial veins (n = 42 veins) and were treated pharmacologically in three ways: (1) control (n = 14); bevacizumab (n = 14); or peginterferon alfa-2a (n = 14). Animals received 2 systemic drug doses 1 month prior to and during the procedure. Vessel patency was determined 24 weeks later using venography.

Results

Venous recanalization occurred in 33.3% of sclerosed facial veins after 4 weeks and 50.0% after 12 and 24 weeks. For animals treated with systemic medication, recanalization occurred less frequently when bevacizumab (14.3%, n = 2/14) (P = 0.04) or peginterferon alfa-2a (7.7%, n = 1/14) (P = 0.01) was administered compared to controls (57.1%, n = 8/14).

Conclusions

Systemic treatment with bevacizumab or peginterferon alfa-2a reduces venous recanalization following sclerotherapy in an animal model. Further studies are indicated to determine whether anti-angiogenic pharmacotherapy can prevent recurrence of venous malformations in humans after sclerotherapy.