{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T10:00:27Z","timestamp":1785060027250,"version":"3.55.0"},"reference-count":8,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vascular malformations (VMs) are congenital anomalies that often cause pain, swelling, disfigurement, and functional impairment. Conventional sclerotherapy, though widely used, typically requires multiple sessions and may yield incomplete resolution. Bleomycin\u2013Electrosclerotherapy (BEST) and Bleomycin\u2010Electroperfusiontherapy (BEPT) combine bleomycin with reversible electroporation to enhance endothelial uptake, potentially improving outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study (January 2024\u2013August 2025) at Christchurch Hospital of 27 patients (40 procedures) with clinically and radiologically confirmed vascular malformations, where bleomycin had been administered percutaneously, intra\u2010arterially or intravenously, followed by electroporation using the IGEA Cliniporator VITAE. Primary outcome was clinical improvement assessed by GAIS. Secondary outcomes included VAS pain scores, number of treatments, complication rates and subgroup analyses. This study is reported in accordance with the STROBE statement for observational studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort included venous (40.7%), lymphatic (18.5%), venolymphatic (7.4%) and glomovenous malformations (11.1%), intramuscular fast\u2010flow vascular anomaly (3.7%), Klippel\u2010Trenaunay spectrum (3.7%), FAVA (3.7%) and arteriovenous malformations (11.1%). Clinical improvement (GAIS 1\u20133) was observed in 24\/27 patients (88.9%; 95% CI 71.9%\u201396.1%). Exceptional improvement or resolution (GAIS 1) was achieved in 37.0% and partial improvement (GAIS 2\u20133) in 51.9%, after a mean of 1.48 sessions. Mean VAS score improved from 6.3 to 2.4 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; Cohen's d\u2009=\u20091.68). Subgroup analysis demonstrated a 100% improvement rate in treatment\u2010na\u00efve patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097; 95% CI 64.6\u2013100%) and in lymphatic malformations (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095; 95% CI 56.6%\u2013100%); both subgroups were small and the wide confidence intervals preclude definitive conclusions. Adverse events included transient sensory nerve loss (18.5%), hyperpigmentation (44.4%) and localised necrosis in intraoral lesions (11.1%), all resolving except for 1 case of permanent hyperpigmentation. No systemic toxicity occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BEST and BEPT are effective adjuncts for vascular malformations, reducing treatment burden compared to conventional sclerotherapy and showing particular promise in microcystic lymphatic malformations and selected high\u2010flow AVMs. Larger multicentre studies with extended follow\u2010up are warranted to confirm safety, efficacy, refine patient selection and optimise dosing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1754-9485.70153","type":"journal-article","created":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T09:21:23Z","timestamp":1785057683000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bleomycin and Reversible Electroporation for the Treatment of Vascular Malformations: A New Zealand Tertiary Centre Experience"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3338-8476","authenticated-orcid":false,"given":"Martin","family":"Krauss","sequence":"first","affiliation":[{"name":"Department of Interventional Radiology Christchurch Hospital  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2217-1456","authenticated-orcid":false,"given":"Michelle","family":"Marais","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology Christchurch Hospital  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Missa Mohd","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology Christchurch Hospital  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"International Society for the Study of Vascular Anomalies \u201cISSVA Classification of Vascular Anomalies 2025 \u201d(2025) https:\/\/www.issva.org\/classification."},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.5469\/neuroint.2019.00213","article-title":"Sclerotherapy for Venous Malformations of Head and Neck: Systematic Review and Meta\u2010Analysis","volume":"15","author":"De Maria L.","year":"2020","journal-title":"Neurointervention"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1097\/PRS.0000000000001924","article-title":"Intralesional Bleomycin Injections for Vascular Malformations: A Systematic Review and Meta\u2010Analysis","volume":"137","author":"Horbach S. E. R.","year":"2016","journal-title":"Plastic and Reconstructive Surgery"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270\u2010025\u201004178\u20105"},{"key":"e_1_2_11_6_1","unstructured":"N. W. M.Khor \u201cSclerotherapy for Vascular Malformations: A Single\u2010Centre Experience of 734 Cases Over 10\u2009Years \u201d(2024) Presented at: IRSA Conference."},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"6425","DOI":"10.1007\/s00330-024-10723-6","article-title":"Outcome of Bleomycin Electrosclerotherapy of Slow\u2010Flow Malformations in Adults and Children","volume":"34","author":"Schmidt V. F.","year":"2024","journal-title":"European Radiology"},{"key":"e_1_2_11_8_1","first-page":"1","article-title":"Bleomycin Electrosclerotherapy in Therapy\u2010Resistant Venous Malformations of the Body","volume":"12","author":"Wohlgemuth W. A.","year":"2024","journal-title":"Journal of Vascular Surgery. Venous and Lymphatic Disorders"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies","volume":"370","author":"Elm E.","year":"2007","journal-title":"Lancet"}],"container-title":["Journal of Medical Imaging and Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1754-9485.70153","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1754-9485.70153","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1754-9485.70153","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T09:21:25Z","timestamp":1785057685000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1754-9485.70153"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,26]]},"references-count":8,"alternative-id":["10.1111\/1754-9485.70153"],"URL":"https:\/\/doi.org\/10.1111\/1754-9485.70153","archive":["Portico"],"relation":{},"ISSN":["1754-9477","1754-9485"],"issn-type":[{"value":"1754-9477","type":"print"},{"value":"1754-9485","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,26]]},"assertion":[{"value":"2025-12-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1754-9485.70153"}}