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VASCULAR DISEASES

A new tale of thalidomide repurposing

Nature Cardiovascular Research volume 1, pages 535–536 (2022)Cite this article

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A prospective observational case-report study now shows that thalidomide can be a well-tolerated, efficacious treatment for complications such as pain, bleeding and ulceration from extracranial arteriovenous malformation.

Arteriovenous malformations (AVMs) are among the most difficult to treat and dangerous vascular malformations. Effective treatments are urgently needed to prevent life-threatening complications. AVMs are formed by a ‘nidus’ of low-resistance vessels that results in direct shunting of blood from high-flow arteries into veins, without the intervening capillary bed and perfusion of adjacent tissue. The pulsatile flow through weakened vessel walls can lead to severe and sometimes life-threatening complications, including pain, ulceration, hemorrhage, stroke and uncontrolled bleeding. Conventional surgical management of AVMs includes embolization followed by surgical resection. However, the risk of complications such as tissue ischemia and necrosis is high, and recurrence within a year following embolization can be over 90% (ref. 1). Due to neovascularization after surgery, the rebound growth can sometimes be worse than the initial disease.

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Fig. 1: Uncontrolled endothelial cell proliferation due to activation of multiple signaling pathways results in increased angiogenesis and AVM.

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Authors and Affiliations

  1. Department of Dermatology, Stanford University School of Medicine, Palo Alto, CA, USA

    Joyce M. C. Teng & Dawn H. Siegel

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  1. Joyce M. C. Teng
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  2. Dawn H. Siegel
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Correspondence to Joyce M. C. Teng.

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The authors declare no competing interests.

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Teng, J.M.C., Siegel, D.H. A new tale of thalidomide repurposing. Nat Cardiovasc Res 1, 535–536 (2022). https://doi.org/10.1038/s44161-022-00087-9

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