Efficacy of polidocanol foam versus bleomycin–polidocanol mini-foam in pediatric head and neck venous malformations

Relevance. Venous malformations of the head and neck in children represent a clinically significant type of vascular anomaly that is challenging to treat due to their morphological features and high risk of recurrence. Modern approaches to sclerotherapy, particularly the use of foam formulations, provide new opportunities for minimally invasive treatment. Objective. To compare the efficacy and safety of 3% polidocanol foam and a novel bleomycin– polidocanol mini-foam formulation in pediatric head and neck venous malformations. Materials and methods. The study included an experimental phase involving 18 laboratory animals and a clinical phase with 82 pediatric patients. The first group underwent sclerotherapy with 3% polidocanol foam, while the second group received a bleomycin-polidocanol mini-foam formulation. Efficacy was evaluated using clinical criteria and MRI findings. Results. The combined therapy group demonstrated a significantly higher rate of complete regression of malformations (87.8% vs. 51.2%). The mean number of procedures required to achieve a positive effect was comparable – 2.16 in the first group vs. 2.76 in the second group. Morphological analysis revealed marked endothelial damage and absence of vascular recanalization in the experimental group treated with the combined foam. Conclusion. Bleomycin–polidocanol mini-foam sclerotherapy demonstrates high therapeutic potential and may be recommended as a first-line treatment for venous malformations of the head and neck in children.