Bevacizumab and interferon reduce venous recanalization following sclerotherapy

Ann M. Kulungowski, Aladdin H. Hassanein, Carolyn C. Foster, Arin K. Greene, Steven J. Fishman*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Purpose 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.

Original languageEnglish (US)
Pages (from-to)1670-1673
Number of pages4
JournalJournal of Pediatric Surgery
Volume51
Issue number10
DOIs
StatePublished - Oct 1 2016

Fingerprint

Sclerotherapy
Interferons
Veins
Phlebography
Animal Models
Ethanol
Bevacizumab
Rabbits
Recurrence
Drug Therapy
peginterferon alfa-2a
Therapeutics
Pharmaceutical Preparations

Keywords

  • Recurrence
  • Sclerotherapy
  • Vascular anomaly
  • Venous malformation

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Kulungowski, Ann M. ; Hassanein, Aladdin H. ; Foster, Carolyn C. ; Greene, Arin K. ; Fishman, Steven J. / Bevacizumab and interferon reduce venous recanalization following sclerotherapy. In: Journal of Pediatric Surgery. 2016 ; Vol. 51, No. 10. pp. 1670-1673.
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abstract = "Purpose 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.",
keywords = "Recurrence, Sclerotherapy, Vascular anomaly, Venous malformation",
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Bevacizumab and interferon reduce venous recanalization following sclerotherapy. / Kulungowski, Ann M.; Hassanein, Aladdin H.; Foster, Carolyn C.; Greene, Arin K.; Fishman, Steven J.

In: Journal of Pediatric Surgery, Vol. 51, No. 10, 01.10.2016, p. 1670-1673.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Bevacizumab and interferon reduce venous recanalization following sclerotherapy

AU - Kulungowski, Ann M.

AU - Hassanein, Aladdin H.

AU - Foster, Carolyn C.

AU - Greene, Arin K.

AU - Fishman, Steven J.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Purpose 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.

AB - Purpose 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.

KW - Recurrence

KW - Sclerotherapy

KW - Vascular anomaly

KW - Venous malformation

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