{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:42:30Z","timestamp":1777941750492,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Endovascular Surg"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Recently, studies have shown that sirolimus is clinically efficacious in the treatment of some low-flow vascular malformations (LFVM). This study aimed to assess the efficacy and safety of sirolimus in treating complex head and neck (H&amp;N) LFVM that were challenging and\/or refractory to standard treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Each patient had baseline and 6-months assessments consisting of clinical history and examination, quality of life (QoL) questionnaires, laboratory investigations, MRI and medical photography. Patients were followed up 1-week and then 1-monthly for 6-months. Wilcoxon signed-rank test was used to compare pre-and 6-months treatment in all 8 domains of RAND 36-Item Short Form Health Survey (SF-36), hospital anxiety and depression scale (HADS), and visual analog score for pain (VAS-P). P &lt; 0.05 was considered significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seven patients (median age 43 years, range 23-65 years) were recruited. Six patients completed the six-months course of therapy with 1 patient withdrawing due to intolerable side effects. All six patients reported reduction of swelling with and without other symptom improvement related to the vascular malformations while on treatment. However, at 1-month review after discontinuation of sirolimus, 5 patients reported return of initial symptoms. Overall, patients demonstrated an improvement in QoL six-months treatment but there was no statistical significance (P &gt; 0.05) in all 8 domains of SF-36, HADS and VAS-P. Five patients demonstrated a minimum 10% decrease in lesion size six-months treatment (median 21%, range 13-40%). A Wilcoxon signed-rank test showed that sirolimus treatment did elicit a statistically significant change in lesion size in either direction (Z = -1.992, P = 0.046). The most common side effects found were dyslipidaemia (n-4) and mouth ulcers (n = 2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In our preliminary experience, sirolimus is effective and safe in treating patients with complex H&amp;N LFVM. This provides an alternative treatment where standard treatment is challenging and\/or refractory.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15385744211010378","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T05:41:12Z","timestamp":1618983672000},"page":"482-490","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Single Center Experience of Sirolimus Therapy in Head and Neck Low-flow Vascular Malformations"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9914-4706","authenticated-orcid":false,"given":"Calver","family":"Pang","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom"},{"name":"Department of Surgical Biotechnology, Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poonam","family":"Jethwa","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Royal Free London NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthie","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Royal Free London NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Khalifa","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Royal Free London NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janice","family":"Tsui","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom"},{"name":"Department of Surgical Biotechnology, Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Royal Free London NHS Foundation Trust, London, United Kingdom"},{"name":"Department of Surgical Biotechnology, Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung Sim","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Royal Free London NHS 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