Vascular anomalies are disorders of the endothelium that affect capillaries, arteries, veins, or the lymphatic system. The overall prevalence of vascular anomalies is approximately 4.5%, mostly due to haemangioma. This systematic review aimed to evaluate the evidence on the efficacy and safety of bleomycin electrosclerotherapy in patients with vascular anomalies compared with standard treatment.

No evidence from controlled trials was available to evaluate efficacy. Regarding the safety of bleomycin electrosclerotherapy, serious adverse events are rare and other side effects are usually mild and self-limiting. A comparison with the safety profile of standard therapy was not possible due to the study designs of the included trials.

The current evidence on bleomycin electrosclerotherapy is mainly based on prospective and retrospective single-arm case series with small sample sizes. The studies have a number of serious limitations. In summary, no clear conclusion can be drawn as to whether bleomycin electrosclerotherapy leads to better results than current treatment standards, as no robust comparative studies are available. Due to the methodological shortcomings of the available evidence and the lack of controlled evidence, the inclusion of bleomycin electrosclerotherapy in the catalogue of benefits is currently not recommended.