The Clinical Study Of Lauromacrogol For The Treatment Of Hemangiomas And Vascular Malformations

Background:Hemangiomas and vascular malformations are very common clinical diseases,representing a broad spectrum of disorders,including those with the involvement of capillaries,lymphatics,veins and arteries.Hemangiomas and vascular malformations contain lots of diseases with different etiology and pathogenesis.Even though there are various treatments,most treatments can target only one or several diseases.Lauromacrogol which is also known as polidocanol,is first used for local anesthesia.It’s not until 1967 that lauromacrogol is found to be used as sclerosant.The mechanism of action of lauromacrogol is:after intravascular injection,it can disturb the lipid metabolism of vascular endothelial calls directly,causing the disposition of fibrous proteins,platelets and red blood cells.Thus an thrombus will form and block the blood vessel.Meanwhile,the chemical action of the drug can cause aseptic inflammation of the injected area,and then the formation of granulation tissue,finally the dense fibrous tissue.In addition,because of the unique molecular properties of lauromacrogol,it can be made into foam formulation for treatment.Lauromacrogol has broad indications in clinical practice as a sclerosant.It is effective for different kinds of diseases,such as hemangiomas and vascular malformations,surface and viscera cysts,lower extremity varicose veins,esophageal and gastric varices and internal hemorrhoids,etc.This study collects a total of 52 patients of hemangiomas or vascular malformations and investigate the curative effect and adverse reaction of foam sclerosant of lauromacrogol.Objective:To evaluate the efficiency and safety of lauromacrogol foam on the treatment of hemangiomas and vascular malformationsMethods:52 patients are identified as the research objects of this study who are diagnosed as hemangiomas or vascular malformations at our department during September 2014 to Janurary 2017.Tessari method is used to make foam sclerosant:1%lauromacrogol is mixed with air in a ratio of 1:3,and pushed more than 20 times.Two scalp needles are punctured into both sides of the lesion.from surrounding normal tissues.After withdrawing blood,the drug is pushed into the lesion slowly while blood is drew slowly on the other side.The treatment ends when the lesion becomes pale and swell.Multiple punctures are needed when the lesion is large.When no blood can be drew out,the drug can be injected directly to the lesion.Treatments should be separated if the lesion is widely distributed.Treatment is applied every two weeks,continuous injections should no more than 6 times.The curative effect is divided into cure,remarkably effective,effective and inefficient.Total effective rate=(the number of cure+the number of remarkably effective+the number of effective)/total number*100%.And the complications such as ulcer,infection,allergic reaction,pigmentation change and scar are observed.Results:After an average of 3.4 injections(1 to 6 times),33 patients(63.5%)were cured,13 patients(25.0%)were remarkably effective,4 patients(7.7%)were effective,and 2 patient(3.8%)were inefficient.1 case appeared transient dry cough and chest tightness during the treatment,the treatment was stopped immediately and the symptoms disappeared after 20 minutes’rest.1 patient felt dizzy immediately after the treatment,and the symptom relieved after 5 minutes’ lying down.This patient developed scar after second treatment.No other local or system side effects such as infection,ulcer,scar,visual impairment or dizzy were observed.Imaging study were applied in several patients for diagnosis and curative effect judgment.Conclusion:Sclerotherapy with lauromacrogol foam is a safe,effective and simple treatment for hemangiomas and vascular malformations.Imaging examination can help the diagnosis and differential diagnosis of hemangiomas and vascular malformations,and can also reflect the curative effect more objectively.