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.
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).
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.