Neurointerventional Radiology, University of California San Francisco, San Francisco, California, USA
Neurointerventional Radiology, University of California San Francisco, San Francisco, California, USA.
J Neurointerv Surg. 2023 Sep;15(9):931. doi: 10.1136/jnis-2022-019255. Epub 2022 Aug 17.
Percutaneous sclerotherapy is an effective technique for treating lymphatic malformations of the head and neck, with clinical success rates exceeding 84%.1 Sodium tetradecyl, which damages lipid membranes and stimulates free radical-induced local damage, and doxycycline, which inhibits angiogenesis, have emerged as the safest and most effective of several available sclerosants.2-4 Although severe periprocedural morbidity is rare, temporary local complications are reported in 14% and skin necrosis or scarring in up to 0.8-5.8% of sclerotherapy procedures.5 As these lesions are frequently located in the face and/or neck, even minor complications can be disfiguring and must be avoided. This technical video describes a 'dual-agent' approach for percutaneous sclerotherapy of macrocystic lymphatic malformations using sodium tetradecyl as a 'primer' followed by doxycycline as a definitive sclerosant (video 1). This technique emphasizes meticulous backtable preparation and effective use of ultrasound and fluoroscopy to minimize complications. neurintsurg;15/9/931/V1F1V1Video 1 .
经皮硬化治疗是治疗头颈部淋巴管畸形的有效技术，其临床成功率超过 84%。1 十四烷基硫酸钠（破坏脂质膜并刺激自由基诱导的局部损伤）和多西环素（抑制血管生成）已成为几种可用硬化剂中最安全有效的药物。2-4 虽然围手术期严重发病率罕见，但在 14%的硬化治疗中报告了暂时的局部并发症，皮肤坏死或瘢痕形成高达 0.8-5.8%。5 由于这些病变通常位于面部和/或颈部，即使是轻微的并发症也可能造成毁容，必须避免。本技术视频描述了一种使用十四烷基硫酸钠作为“底漆”，随后使用多西环素作为确定性硬化剂的“双药”经皮硬化治疗大囊型淋巴管畸形的方法（视频 1）。该技术强调了仔细的后台准备和有效利用超声和透视来最小化并发症。neurintsurg;15/9/931/V1F1V1Video 1。
