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Safety and Efficacy of Bleomycin Slow Infusion Sclerotherapy Using a Syringe Pump for Microcystic and Mixed Lymphatic Malformations

  • Clinical Investigation
  • VENOUS INTERVENTIONS
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Abstract

Purpose

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).

Materials and Methods

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.

Results

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.

Conclusions

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 of Evidence

Level 4, Case series.

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Abbreviations

LM:

Lymphatic malformation

MRI:

Magnetic resonance imaging

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Acknowledgements

We would like to thank Wade Martin of Emareye Medical Editing for his critical revision of this manuscript.

Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Radiology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944, Republic of Korea

    Jung Guen Cha, Jongmin Lee, Sang Yub Lee & Jihoon Hong

  2. Department of Plastic and Reconstructive Surgery, CMRI, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Ho Yun Chung

  3. Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Seok Jong Lee

  4. Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Seung Huh

  5. Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Ji Yoon Kim

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  1. Jung Guen Cha
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  2. Jongmin Lee
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  3. Sang Yub Lee
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Corresponding author

Correspondence to Sang Yub Lee.

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Conflict of interest

The authors declare that they have no conflict of interest.

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. Institutional Review Board (IRB) approval was obtained for this study.

Informed Consent

Indivisual written informed consents for the sclerotherapy procedures were obtained from all patients or their authorized trustees.

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Cha, J.G., Lee, J., Lee, S.Y. et al. Safety and Efficacy of Bleomycin Slow Infusion Sclerotherapy Using a Syringe Pump for Microcystic and Mixed Lymphatic Malformations. Cardiovasc Intervent Radiol 45, 1288–1294 (2022). https://doi.org/10.1007/s00270-022-03224-w

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  • DOI: https://doi.org/10.1007/s00270-022-03224-w

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