Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea.
Department of Plastic and Reconstructive Surgery, CMRI, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Cardiovasc Intervent Radiol. 2022 Sep;45(9):1288-1294. doi: 10.1007/s00270-022-03224-w. Epub 2022 Jul 21.
To evaluate the safety and efficacy of bleomycin infusion sclerotherapy using a syringe pump in microcystic and mixed (microcystic components with the presence of a cyst over 1 cm) lymphatic malformations (LMs).
Patients who received bleomycin sclerotherapy with a syringe pump for microcystic or mixed LMs were reviewed. Cystic components of LMs were accessed under sonographic guidance, followed by injection of an opacified bleomycin solution using a syringe pump (infusion rate, 10-20 mL/h) under fluoroscopic guidance. Imaging outcomes were graded as complete (> 90% size reduction), partial (25-90%), or no response (< 25%). Clinical outcomes and procedure-related complications were also reviewed.
Forty-nine patients with 81 sclerotherapies were analyzed. The mean age was 17 years (range 0.1-65 y). Thirty-one (63%) patients had microcystic LMs, and 18 (37%) had mixed. A mean of 1.7 sessions (range 1-4) of sclerotherapy was performed using a mean cumulative dose of bleomycin of 10.8 U (range 1.5-39 U). The mean infusion time was 39 min (range 14-130 min). Regarding imaging outcomes, there was a complete response in 29% (n = 14), a partial response in 57% (n = 28), and no response in 14% (n = 7). Regarding clinical outcomes, there was a complete response in 39% (n = 19), a partial response in 51% (n = 25), and no response in 10% (n = 5). According to the CIRSE classification, no major complications were identified.
Bleomycin slow infusion sclerotherapy provides gradual filling of sclerosant to target microcystic components. This technique is safe and feasible for the management of microcystic or mixed LMs.
Level 4, Case series.
评估使用注射器泵行博来霉素腔内注射硬化治疗微囊型和混合（微囊型成分伴直径＞1 cm 的囊肿）淋巴管畸形（LM）的安全性和疗效。
回顾性分析接受注射器泵博来霉素硬化治疗的微囊型或混合 LM 患者。在超声引导下穿刺 LM 的囊性成分，然后在透视引导下使用注射器泵（输注速度 10-20 mL/h）注入显影博来霉素溶液。根据影像学结果的完全缓解（＞90%体积缩小）、部分缓解（25%-90%）和无缓解（＜25%）进行分级。还评估了临床疗效和与操作相关的并发症。
共分析了 49 例 81 次硬化治疗患者。平均年龄 17 岁（0.1-65 岁）。31 例（63%）患者为微囊型 LM，18 例（37%）为混合型。平均进行 1.7 次（1-4 次）治疗，平均累积博来霉素剂量为 10.8 U（1.5-39 U）。平均输注时间为 39 min（14-130 min）。影像学结果显示完全缓解 29%（n=14），部分缓解 57%（n=28），无缓解 14%（n=7）。临床疗效显示完全缓解 39%（n=19），部分缓解 51%（n=25），无缓解 10%（n=5）。根据 CIRSE 分级，未发现重大并发症。
博来霉素缓慢输注硬化治疗可逐渐使硬化剂充盈目标微囊型成分。该技术对于微囊型或混合 LM 的治疗是安全可行的。
4 级，病例系列研究。
