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Dual-agent percutaneous sclerotherapy technique for macrocystic lymphatic malformations.

Author information

Affiliations

  • 1. Neurointerventional Radiology, University of California San Francisco, San Francisco, California, USA
      Authors
    • Caton MT 1
    (1 author)
  • 2. Neurointerventional Radiology, University of California San Francisco, San Francisco, California, USA.
      Authors
    • Baker A 2
    • Smith ER 2
    • Cooke DL 2
    • Dowd CF 2
    (4 authors)
  • 3. Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
      Authors
    • Perez E 3
    (1 author)
  • 4. Neurology, University of California San Francisco, San Francisco, California, USA.
      Authors
    • Hemphill K 4
    (1 author)

ORCIDs linked to this article

Journal of Neurointerventional Surgery, 17 Aug 2022, 15(9):931
https://doi.org/10.1136/jnis-2022-019255 PMID: 35977819 

Abstract 

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 .

Full text links 

Read article at publisher's site: https://doi.org/10.1136/jnis-2022-019255

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