Document Detail


Percutaneous sclerotherapy of lymphatic malformations with doxycycline.
MedLine Citation:
PMID:  19093794     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Lymphatic malformations (LMs) can be effectively treated by percutaneous intralesional injection of a variety of sclerosant drugs. This study aims to evaluate the efficacy of doxycycline in the treatment of LMs. METHODS AND RESULTS: We reviewed the medical records of all patients with LMs who underwent sclerotherapy with doxycycline between January 1, 2003 and September 1, 2004 at Children's Hospital Boston. Follow-up imaging was performed to assess for change in lesion size. Surveys were sent to all study patients, to assess perceived improvements in symptoms and satisfaction with the results. Sixty sclerotherapy procedures were performed on 41 patients in the 20-month study period. The median age was 6.9 years (3 mo-31 y). The most common location was cervicofacial (66%), followed by truncal (19%) and extremity (15%). The most common lesion type was macrocystic (49%), followed by combined (44%) and microcystic (7%). The major and minor complication rates were 2% and 10%, respectively. The mean outcome score by imaging was 4.41/5 with a 95% CI of [4.13-4.68] corresponding to about an 83% reduction in lesion size, and by patient survey was 4.47/5 with a 95% CI of [4.15-4.79] corresponding to between a good to complete response. Higher complication rates were associated with microcystic and combined lesions (p = 0.03), and greater doxycycline dose (p = 0.05). CONCLUSIONS: Doxycycline is a safe and effective sclerosant for LMs. Greater follow-up is necessary to quantify long-term outcomes and assess the risks of lesion recurrence.
Authors:
Patricia E Burrows; Ragheed K Mitri; Ahmad Alomari; Horacio M Padua; David J Lord; Mary Beth Sylvia; Steven J Fishman; John B Mulliken
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Lymphatic research and biology     Volume:  6     ISSN:  1539-6851     ISO Abbreviation:  Lymphat Res Biol     Publication Date:  2008  
Date Detail:
Created Date:  2008-12-19     Completed Date:  2009-03-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101163587     Medline TA:  Lymphat Res Biol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  209-16     Citation Subset:  IM    
Affiliation:
Vascular Anomalies Center, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA. pburrows@chpnet.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Child
Child, Preschool
Doxycycline / therapeutic use*
Female
Humans
Infant
Lymphatic Abnormalities / drug therapy*,  pathology
Lymphatic System / pathology*
Male
Retrospective Studies
Sclerosing Solutions / therapeutic use
Sclerotherapy / methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Sclerosing Solutions; 564-25-0/Doxycycline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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