Vascular Malformations
Special Indications
Vascular malformations are the only non-oncological application area. The approach rests on potentiating the sclerotherapeutic effect of bleomycin with electroporation and has been studied particularly in venous and lymphatic malformations.
32total publications
18clinical studies
1preclinical studies
7reviews
2010–2026publication span
Evidence Status by Regime
Reversible electroporation (RE-ECT)
32publications
18clinical
1preclinical
Clinical Evidence
2010–2026 · In Routine Clinical Use
Mechanisms Reported in This Area
Terms were detected by automatic matching over publication abstracts; the figure gives the number of publications containing the term.
Increased Intracellular Bleomycin Accumulation 27
Reversible Membrane Permeabilisation 9
Electrode Geometry and Placement 4
Potentiation of Cytotoxic Drug Permeability 3
Antivascular Effect and Vessel Disruption 2
Vascular Lock Effect 2
Necrosis and Necroptosis 2
Electric Field Distribution and Modelling 2
Muscle Contraction and Anaesthesia Requirement 1
Increased Intracellular Cisplatin Accumulation 1
Irreversible Pore Formation and Cell Death 1
Optimisation of Pulse Parameters 1
Study Type Distribution
Bar length is scaled to the most common study type; the percentage gives the share of the whole area. Colour marks the evidence tier of the study type, the same scale as the evidence map.
| Study type | Publications | Share within this area |
|---|---|---|
| Randomized Clinical Trial | 2 | 6% |
| Prospective Clinical Study | 1 | 3% |
| Clinical Study | 8 | 25% |
| Retrospective Clinical Study | 6 | 19% |
| Case Series | 1 | 3% |
| Case Report | 4 | 12% |
| Systematic Review / Meta-Analysis | 2 | 6% |
| Review | 5 | 16% |
| Animal Study | 1 | 3% |
| Preprint | 1 | 3% |
| Correction / Erratum | 1 | 3% |
Literature Evidence Table
32 publications listed in order of evidence strength. Click a title to open the citation, mechanism and full abstract drawer.
| Regime | Publication | Year | Study type | Model | Mechanism | Abstract |
|---|---|---|---|---|---|---|
| Reversible | Horbach et al · BMJ Open | 2017 | Randomized Clinical Trial | Human | Increased Intracellular Bleomycin Accumulation | Introduction: The current state-of-the-art treatment modality for hypertrophic capillary malformations (CMs), laser therapy, has a considerable rate of non-responders and recurrence. Intrale… |
| Reversible | Zhang et al · J Oral Maxillofac Surg | 2013 | Randomized Clinical Trial | Human | Muscle Contraction and Anaesthesia Requirement | Purpose: Intranasal dexmedetomidine is noninvasive and has been reported as premedication for children undergoing surgery. The aim of this study was to evaluate the safety and efficacy of in… |
| Reversible | Deleu et al · CVIR Endovasc | 2025 | Prospective Clinical Study | Human | Increased Intracellular Bleomycin Accumulation | Background: Slow-flow vascular malformations are persistent congenital vascular lesions that progressively disrupt tissue structure and function, often causing pain, swelling, and esthetic c… |
| Reversible | Mistretta et al · Neuroradiology | 2026 | Clinical Study | Human | Increased Intracellular Bleomycin Accumulation, Reversible Membrane Permeabilisation | A rare extra- and intracranial mixed vascular malformation involving the scalp soft tissues and the dura mater, associated with skull erosion, and characterized by both a low-flow capillary-… |
| Reversible | Stabuc et al · J Vis Exp | 2026 | Clinical Study | Human | Increased Intracellular Bleomycin Accumulation, Reversible Membrane Permeabilisation | Bleomycin electrosclerotherapy (BEST) is an emerging, minimally invasive treatment for treating slow-flow vascular malformations. Following intralesional administration of bleomycin, reversi… |
| Reversible | Obereisenbuchner et al · Cardiovasc Intervent Radiol | 2025 | Clinical Study | Human | Reversible Membrane Permeabilisation, Increased Intracellular Bleomycin Accumulation | Purpose: This study aims to evaluate and compare safety and clinical outcomes of reversible electroporation with either intravenous (BEST) or intraarterial (BEET) Bleomycin application treat… |
| Reversible | Schmidt et al · Eur Radiol | 2024 | Clinical Study | Human | Increased Intracellular Bleomycin Accumulation | Objectives: To evaluate the safety and clinical outcome of bleomycin electrosclerotherapy (BEST) for treating extracranial slow-flow malformations. Methods: In this retrospective investigati… |
| Reversible | Wohlgemuth et al · J Vasc Surg Venous Lymphat Disord | 2021 | Clinical Study | Human | Increased Intracellular Bleomycin Accumulation, Reversible Membrane Permeabilisation | Objective: Bleomycin is one of the most commonly used agents in sclerotherapy for slow-flow vascular malformations worldwide. However, its efficiency remains unknown. The objective of the pr… |
| Reversible | Zhong et al · Br J Oral Maxillofac Surg | 2016 | Clinical Study | Human | – | We describe the results of electrochemical treatment of extensive venous malformations in the oral and cervicofacial region in 29 patients. Platinum needles were inserted into the lesions un… |
| Reversible | Li et al · Chin J Integr Med | 2013 | Clinical Study | Human | – | Objective: To evaluate the efficacy and safety of electrochemotherapy in treating venous malformations. Methods: Electrochemotherapy was applied to 665 patients with venous malformations of … |
| Reversible | Keuker · Journal of Radiology Nursing | 2010 | Clinical Study | Human | Increased Intracellular Bleomycin Accumulation | Venous malformations are congenital anomalies of the vascular system. The injection of bleomycin (a cytotoxic, antitumour drug) into the lesion is a safe and effective treatment for low-flow… |
| Reversible | Krauss et al · J Med Imaging Radiat Oncol | 2026 | Retrospective Clinical Study | Human | Increased Intracellular Bleomycin Accumulation, Reversible Membrane Permeabilisation | Background: Vascular malformations (VMs) are congenital anomalies that often cause pain, swelling, disfigurement, and functional impairment. Conventional sclerotherapy, though widely used, t… |
| Reversible | Loeser et al · Rofo | 2026 | Retrospective Clinical Study | Human | Increased Intracellular Bleomycin Accumulation, Reversible Membrane Permeabilisation | Purpose: Sclerotherapy remains the standard for interventional treatment of slow-flow vascular malformations. However, bleomycin electrosclerotherapy (BEST) has shown promising results in th… |
| Reversible | Goldann et al · Pediatr Res | 2025 | Retrospective Clinical Study | Human | Increased Intracellular Bleomycin Accumulation | Background: This prospective study evaluates the effectiveness and safety of Bleomycin electrosclerotherapy (BEST) for treating slow-flow vascular malformations in a pediatric cohort. While … |
| Reversible | Loeser et al · Rofo | 2025 | Retrospective Clinical Study | Human | Increased Intracellular Bleomycin Accumulation, Reversible Membrane Permeabilisation | Purpose: The objective of the study was to retrospectively investigate the efficacy, technical feasibility, and patient safety of bleomycin electrosclerotherapy for lymphatic malformations a… |
| Reversible | Obereisenbuchner et al · Cardiovasc Intervent Radiol | 2025 | Retrospective Clinical Study | Human | Increased Intracellular Bleomycin Accumulation | Introduction: Bleomycin-electrosclerotherapy (BEST) is a novel treatment for slow-flow vascular malformations (SFVMs), most studied in venous malformations. This study specifically evaluated… |
| Reversible | Liu et al · J Vasc Surg Venous Lymphat Disord | 2024 | Retrospective Clinical Study | Human | Increased Intracellular Bleomycin Accumulation | Objective: This study aims to investigate the difference in safety and efficacy between two treatments for venous malformations (VMs), electrochemotherapy combined with polidocanol foam (ECP… |
| Reversible | Guida et al · Children (Basel) | 2025 | Case Series | Human | Increased Intracellular Bleomycin Accumulation | Background: Vascular malformations are relatively common in children. Current therapeutic strategies include observation, medical therapy, sclerotherapy or embolization, laser therapy, cryoa… |
| Reversible | Downes et al · Cureus | 2026 | Case Report | Human | Increased Intracellular Bleomycin Accumulation, Reversible Membrane Permeabilisation | Bleomycin electrosclerotherapy (BEST) is a recently introduced treatment for lymphovascular malformations that combines intralesional bleomycin injection under image guidance with a precisel… |
| Reversible | Huppert et al · J Dtsch Dermatol Ges | 2025 | Case Report | Human | Increased Intracellular Bleomycin Accumulation, Reversible Membrane Permeabilisation | Dear Editors, We present a 59-year-old female patient with a venous malformation. Arising from a vasculogenetic developmental disorder, vascular malformations are rare, congenital malformati… |
| Reversible | Loeser et al · Cardiovasc Intervent Radiol | 2024 | Case Report | Human | Increased Intracellular Bleomycin Accumulation | stic Lymphatic Malformation with Bleomycin Electrosclerotherapy Followed by Partial Resection J. H. Loeser1 • U. Kisser2 • L. Dießel3 • S. von der Heydt1 • O. Bidakov1 • C. Loberg1 • W. A. W… |
| Reversible | Dalmády et al · Pediatrics | 2020 | Case Report | Human | Increased Intracellular Bleomycin Accumulation | The treatment of microcystic and combined lymphangiomas, especially in the head and neck region, is still a challenge because the lymphangiomas do not respond to conventional therapies and t… |
| Reversible | Gehr et al · Cardiovasc Intervent Radiol | 2026 | Systematic Review / Meta-Analysis | Human | Increased Intracellular Bleomycin Accumulation | Purpose: To review the available evidence on the effectiveness and safety of bleomycin electrosclerotherapy (BEST) for slow-flow vascular malformations. Materials and methods: A systematic r… |
| Reversible | Michailidis et al · Clin Pract | 2025 | Systematic Review / Meta-Analysis | Literature Analysis | Increased Intracellular Bleomycin Accumulation | Background : Vascular malformations (VMs) are congenital anomalies of the vascular system-capillary, venous, lymphatic, arteriovenous, or combined-frequently associated with notable morbidit… |
| Reversible | Lisec et al · Radiol Oncol | 2026 | Review | Animal (In Vivo) | Increased Intracellular Bleomycin Accumulation, Potentiation of Cytotoxic Drug Permeability | Background: Bleomycin electrosclerotherapy (BEST) is an emerging treatment option for vascular malformations (VMs), predominantly slow-flow venous malformations, with increasing use in other… |
| Reversible | Muir et al · Radiol Oncol | 2024 | Review | Human | Increased Intracellular Bleomycin Accumulation, Antivascular Effect and Vessel Disruption | Background: Bleomycin ElectroScleroTherapy (BEST) is a new approach in the treatment of vascular malformations. After bleomycin is administered to the malformation, electric pulses are appli… |
| Reversible | Muir et al · Radiol Oncol | 2023 | Review | Human | Increased Intracellular Bleomycin Accumulation | Background: Biomedical applications of electroporation are expanding out of the field of oncology into vaccination, treatment of arrhythmias and now in the treatment of vascular malformation… |
| Reversible | Horbach SER · – | 2019 | Review | Literature Analysis | – | MANAGEMENT OF VASCULAR MALFORMATIONS SOPHIE E.R. HORBACH MANAGEMENT OF UITNODIGING Voor het bijwonen van de openbare verdediging van het proefschrift MANAGEMENT OF VASCULAR MALFORMATIONS DIA… |
| Reversible | Horbach SER · – | 2018 | Review | Literature Analysis | Increased Intracellular Bleomycin Accumulation | The current state of the art treatment modality for hypertrophic capillary malformations, laser therapy, has a considerable rate of non-responders and recurrence. Intralesional bleomycin inj… |
| Reversible | Haehl et al · J Pediatr Surg | 2025 | Animal Study | Animal (In Vivo) | Increased Intracellular Bleomycin Accumulation | Rationale and objectives: Bleomycin electrosclerotherapy (BEST) is a promising treatment for slow-flow vascular malformations (SFVMs). Due to limited paediatric data, this study aimed to ass… |
| Reversible | Guida et al · – | 2025 | Preprint | – | Increased Intracellular Bleomycin Accumulation | Background: Vascular malformations are relatively common in children. Current therapeutic strategies include observation, pharmacological therapy, sclerotherapy, laser therapy, embolization,… |
| Reversible | Anon · BMJ Open | 2018 | Correction / Erratum | – | – | : study protocol for a randomised within-patient controlled pilot trial Horbach SER, Wolkerstorfer A, de Bruin DM, et al. Electrosclerotherapy for capillary malformations: study protocol for… |
Limitations
The counts on this page are bounded by the scope of the source PDF archive and are not a systematic review of the area's literature. Study type and mechanism labels are derived automatically; for critical decisions consult the full texts of the publications listed. The evidence level reflects the number of publications, not their methodological quality.