Conclusion
Sirolimus still is a new treatment option for vascular anomalies that
has shown to provide some benefit to patients, especially with LM and
VM. The safety profile has generally been favorable, although different
patient populations might be more prone to complications. The results of
our retrospective survey of the “off-label” use of sirolimus in
different vascular anomalies illustrates the risk of SAEs including
fatal outcomes in these patients. This highlights the importance of a
close follow-up in these patients as well as the need for further
clinical studies to establish the safety profile of sirolimus, the
incidence of SAEs in different patient populations and the optimal
antibiotic prophylaxis.