PT  - JOURNAL ARTICLE
AU  - V. Da Ros
AU  - M. Iacobucci
AU  - F. Puccinelli
AU  - L. Spelle
AU  - G. Saliou
TI  - Lymphographic-Like Technique for the Treatment of Microcystic Lymphatic Malformation Components of <3 mm
AID  - 10.3174/ajnr.A5449
DP  - 2018 Nov 30
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2017/11/30/ajnr.A5449.short
4100  - http://www.ajnr.org/content/early/2017/11/30/ajnr.A5449.full
AB  - 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.LMlymphatic malformationmLMmicrocystic lymphatic malformationLL-Tlymphographic-like technique