E-118 Minimally invasive fluproscopy-guided percutaneous bleomycin sclerotherapy for craniofacial venolymphatic malformations in children

Purpose To evaluate the effectiveness and safety of image-guided percutaneous bleomycin sclerotherapy as a minimally invasive treatment approach for craniofacial (veno)lymphatic malformations in children and adolescents. Material and Methods We retrospectively reviewed our prospectively maintained Neuro IR database between January 2018 and June 2020 and identified all children and adolescents (1 to 19 years) who underwent percutaneous fluoroscopy guided bleomycin sclerotherapy for craniofacial (veno)lymphatic malformations. Patient clinical and imaging follow up data was collected. Results We identified 4 patients (2 female patients) between 20 months and 12 years old who presented with clinical and radiographic craniofacial (veno)lymphatic malformations. Two lesions were macrocystic, 1 microcystic and 1 mixed. No procedural complications ensued. On first follow up examination 2 patients report obvious decrease in size of the malformation which is confirmed with ultrasound and/or visual inspection. One patient subjectively reported minimal decrease in size with the ultrasound evaluation not showing any change from prior to the procedure. One patient who showed initial decrease in size of the lesion already underwent a second sclerotherapy session and is awaiting his next follow up appointment. The other 2 patients are scheduled to undergo their next sclerotherapy session as well. One patient did not reach the first follow up time point yet. Conclusion Sclerotherapy should be considered in selected patients with craniofacial (veno)lymphatic malformations as it represents a safe and successful treatment option, especially if surgical excision is considered challenging, with a high risk of complication and postoperative recurrence. Patients and parents have to be aware that sclerotherapy may require several sessions to achieve results. Generally, patients and parents are satisfied with sclerotherapy treatment outcomes, specifically the cosmetic results. Disclosures A. Kuhn: None. A. Puri: 1; C; NIH, Stryker Neurovascular, Medtronic, Cerenovus. 2; C; Microvention, QApel, Perfuze Medical, Arsenal Medical, Merit Medical, Stryker Neurovascular, Medtronic, Cerenovus. 4; C; InNeuroCo Inc, Galaxy therapeutics, Agile Medical, Perfuze medical and NTI. C. Zoppo: None. K. de Macedo Rodrigues: None. F. Massari: None. M. Gounis: 1; C; National Institutes of Health (NIH), the United States – Israel Binational Science Foundation, Anaconda, ApicBio, Axovant, Cerenovus, Cook Medical, Gentuity, Imperative Care, InNeuroCo, Magneto. 2; C; Cerenovus, Imperative Care, phenox, Medtronic Neurovascular, Route 92 Medical, Stryker Neurovascular. 4; C; Imperative Care, InNeuroCo and Neurogami. J. Singh: None.