V Da Ros1,2, M Iacobucci1,3, F Puccinelli4, L Spelle1, G Saliou5. 1. From the Department of Neuroradiology (V.D.R., M.I., L.S., G.S.), Bicêtre Hospital, Le Kremlin Bicêtre Cedex, France. 2. Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy (V.D.R.), Policlinico Tor Vergata, Rome, Italy. 3. Department of Bioimaging and Radiological Sciences (M.I.), Policlinico "A. Gemelli," Rome, Italy. 4. Department of Neuroradiology (F.P., G.S.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 5. Department of Neuroradiology (F.P., G.S.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. guillaume.saliou@chuv.ch.
Abstract
BACKGROUND AND PURPOSE: The treatment of microcystic lymphatic malformations remains challenging. Our aim was to describe the lymphographic-like technique, a new technique of slow bleomycin infusion for the treatment of microcyst components of <3 mm, performed at our institution. MATERIALS AND METHODS: A retrospective analysis of a prospectively collected lymphatic malformation data base was performed. Patients with at least 1 microcystic lymphatic malformation component demonstrated on MR imaging treated by lymphographic-like technique bleomycin infusion were included in the study. Patient interviews and MR imaging were performed to assess subjective and objective (microcystic lymphatic malformation size decrease of >30%) clinical improvement, respectively. Patients were reviewed 3 months after each sclerotherapy session. Lymphographic-like technique safety and efficacy were assessed. RESULTS: Between January 2012 and July 2016, sixteen patients (5 males, 11 females; mean age, 15 years; range, 1-47 years) underwent the bleomycin lymphographic-like technique for microcystic lymphatic malformations. Sixty sclerotherapy sessions were performed, with a mean of 4 sessions per patient (range, 1-8 sessions) and a mean follow-up of 26 months (range, 5-58 months). We observed no major and 3 minor complications: 1 eyelid infection, 1 case of severe postprocedural nausea and vomiting, and 1 case of skin discoloration. One patient was lost to follow-up. Overall MR imaging objective improvement was observed in 5/16 (31%) patients; overall improvement of clinical symptoms was obtained in 93% of treated patients. CONCLUSIONS: The bleomycin lymphographic-like technique for microcystic lymphatic malformations is safe and feasible with objective improvement in about one-third of patients. MR signal intensity changes after the lymphographic-like technique are associated with subjective improvement of the patient's symptoms.
BACKGROUND AND PURPOSE: The treatment of microcystic lymphatic malformations remains challenging. Our aim was to describe the lymphographic-like technique, a new technique of slow bleomycin infusion for the treatment of microcyst components of <3 mm, performed at our institution. MATERIALS AND METHODS: A retrospective analysis of a prospectively collected lymphatic malformation data base was performed. Patients with at least 1 microcystic lymphatic malformation component demonstrated on MR imaging treated by lymphographic-like technique bleomycin infusion were included in the study. Patient interviews and MR imaging were performed to assess subjective and objective (microcystic lymphatic malformation size decrease of >30%) clinical improvement, respectively. Patients were reviewed 3 months after each sclerotherapy session. Lymphographic-like technique safety and efficacy were assessed. RESULTS: Between January 2012 and July 2016, sixteen patients (5 males, 11 females; mean age, 15 years; range, 1-47 years) underwent the bleomycin lymphographic-like technique for microcystic lymphatic malformations. Sixty sclerotherapy sessions were performed, with a mean of 4 sessions per patient (range, 1-8 sessions) and a mean follow-up of 26 months (range, 5-58 months). We observed no major and 3 minor complications: 1 eyelid infection, 1 case of severe postprocedural nausea and vomiting, and 1 case of skin discoloration. One patient was lost to follow-up. Overall MR imaging objective improvement was observed in 5/16 (31%) patients; overall improvement of clinical symptoms was obtained in 93% of treated patients. CONCLUSIONS: The bleomycin lymphographic-like technique for microcystic lymphatic malformations is safe and feasible with objective improvement in about one-third of patients. MR signal intensity changes after the lymphographic-like technique are associated with subjective improvement of the patient's symptoms.
Authors: Gulraiz Chaudry; Patricia E Burrows; Horacio M Padua; Brian J Dillon; Steven J Fishman; Ahmad I Alomari Journal: J Vasc Interv Radiol Date: 2011-08-06 Impact factor: 3.464
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Authors: Patricia E Burrows; Ragheed K Mitri; Ahmad Alomari; Horacio M Padua; David J Lord; Mary Beth Sylvia; Steven J Fishman; John B Mulliken Journal: Lymphat Res Biol Date: 2008 Impact factor: 2.589