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This study specifically evaluated its safety and clinical outcome in lymphatic\/lymphatic-dominant lympho-venous malformations (LMs\/ld-LVMs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A monocentric cohort with symptomatic LMs or ld-LVMs treated by BEST was retrospectively assessed. A treatment-specific, patient-reported questionnaire assessed overall clinical response (complete response: symptom-free, partial response: improved symptoms, no response: unchanged symptoms, progression of symptoms), subjective health-related quality of life (QoL; optimal, improved, unchanged, worsening), pain (numerical rating scale, NRS), and postprocedural skin discolouration (yes\/no). Pre and postprocedural lesion size was measured in three planes on MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-seven treatments were performed in 20 patients with 14 LMs and six ld-LVMs (11 microcystic, five mixed, and four macrocystic subtypes). Patients received 1.4\u2009\u00b1\u20090.6 treatments with a median bleomycin dose of 7\u00a0mg (range 2\u201315\u00a0mg). After BEST, 7\/20 (35%) patients reported complete response, 10\/20 (50%) partial response, and 3\/20 (15%) no response. Health-related QoL was stated as optimal in 10\/20 (50%) and as improved in 4\/20 (20%) patients. Median pain NRS was reduced from 6 (3\u201310) to 2 (0\u20136). Postprocedural skin discolouration occurred in 11\/20 (55%) patients. Follow-up MR imaging revealed lesion size reduction from mean maximum volume of 793 cm\n                      <jats:sup>3<\/jats:sup>\n                      (IQR 155\u20132199 cm\n                      <jats:sup>3<\/jats:sup>\n                      ) to 548 cm\n                      <jats:sup>3<\/jats:sup>\n                      (IQR 71\u20131059 cm\n                      <jats:sup>3<\/jats:sup>\n                      ). Total complication rate (CIRSE grade 3\u20134) was 11.1%. No differences in all outcome parameters regarding LMs subtypes were assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BEST demonstrates efficacy and acceptable safety treating LMs and ld-LVMs, including challenging microcystic lesions previously considered difficult to treat.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3b, Retrospective Cohort Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00270-025-04169-6","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T23:08:50Z","timestamp":1756940930000},"page":"1428-1437","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Safety and Clinical Outcome of Bleomycin-Electrosclerotherapy (BEST) Treating Lymphatic Malformations (LMs)"],"prefix":"10.1007","volume":"48","author":[{"given":"Florian","family":"Obereisenbuchner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Borisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Puhr-Westerheide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Deniz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdi","family":"Cay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Schirren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Biechele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Schregle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"H\u00e4berle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Haehl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Hartl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Fr\u00f6ba-Pohl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Kashani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Ricke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Seidensticker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Wildgruber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7067-2203","authenticated-orcid":false,"given":"Vanessa F.","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"issue":"2","key":"4169_CR1","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1055\/a-1728-5686","volume":"42","author":"VF Schmidt","year":"2022","unstructured":"Schmidt VF, Olivieri M, H\u00e4berle B, Masthoff M, Deniz S, Sporns PB, et al. 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The remaining authors of this manuscript declare that the research is conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"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. The retrospective study was approved by the local ethics committee (LMU University Hospital, Munich, protocol No. 21-0943).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"This study has obtained IRB approval from (indicate the relevant board) and the need for informed consent was waived.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}},{"value":"Consent for publication was obtained for every individual person\u2019s data included in the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}}]}}