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Therapy of lymphatic malformations or isolated lymphatic components in combined slow-flow malformations with
Julius Henry Loeser1, Moritz Guntau2, Oleksandr Bidakov1
1Radiology, University Hospital Halle, Halle Saale, Germany.
Purpose:
The objective of the study was to retrospectively investigate the efficacy, technical feasibility, and patient safety of bleomycin electrosclerotherapy for lymphatic malformations and lymphatic components of combined veno-lymphatic malformations.
Materials And Methods:
Between May 2019 and December 2021, this retrospective, single-center study analyzed the safety and feasibility of bleomycin electrosclerotherapy in patients with lymphatic or combined veno-lymphatic malformations. The procedures, performed under imaging guidance, involved intralesional or intravenous bleomycin injection followed by reversible electroporation. Lesion sizes were measured pre- and post-treatment using T2 fatsat magnetic resonance imaging. Previous treatments, clinical symptoms, intervention details, and complications were documented and analyzed.
Results:
In 21 interventions, 24 lymphatic malformations of 12 patients (mean age: 14.75 years (range: 10 days-35 years; 5 women, 7 men)) were treated. The average bleomycin dose was 3.65 mg per treatment session (range: 0.5-15 mg). Before the interventions, the mean volume of the treated malformation was 88.76 cm3 (range: 0.38-541.5 cm3) and after treatment it was 36.7 cm3 (range: 0-204.97 cm3), resulting in an average volume reduction of 54.8%. Among the observed side effects, the most frequent were a temporary postinterventional local inflammatory response and temporary skin discoloration at the injection sites. An additional improvement of clinical symptoms was achieved in all patients after a mean follow-up of 8.36 months.
Conclusion:
Bleomycin electrosclerotherapy appears to be an effective, technically feasible, and safe treatment option for patients with lymphatic malformations but further studies using a prospective approach and longer post-interventional observation period in a larger study population are required.
Key Points:
· BEST is a new therapeutic option for lymphatic malformations.. · Different needle electrodes can be used to specifically treat different types of LMs.. · Typical side effects of BEST appear to be minor, ranging from partly intentional, local inflammation to temporary skin discoloration..
Citation Format:
· Loeser JH, Guntau M, Bidakov O et al. Therapy of lymphatic malformations or isolated lymphatic components in combined slow-flow malformations with bleomycin electrosclerotherapy (BEST). Rofo 2025; DOI 10.1055/a-2648-6555.
