The use of Sirolimus for an unresectable and refractory venous malformation: A case series
Abstract
Vascular malformations (VM) may become symptomatic and extensive, leading to deranged coagulation and bleeding. Sirolimus®, an antiangiogenic agent, has recently emerged as treatment for VM. We report its short-term outcomes for VMs of the extremities. Case 1: A 47-year-old female reported left forearm pain. MRI confirmed a VM. Lesion shrinkage and pain relief were not achieved despite sclerotherapy. After 5 months on Sirolimus®, improved pain, decreased forearm circumference and decreased lesion size on MRI were observed. Case 2: 62-year-old male reported left knee pain. MRI and biopsy confirmed a VM. After 3 months on Sirolimus®, improved pain, decreased leg circumference, and decreased lesion size on MRI were observed. Our series demonstrates that Sirolimus® is efficacious in downsizing VMs with resultant symptom relief in the short-term. Other series has likewise shown effectivity in extensive and refractory lesions, with benefits outweighing side effects.
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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