Ultrasound‐guided intralymphatic immunotherapy: A single‐center trial of a clinical skills training programme

Skaarup, Søren Helbo; Graumann, Ole; Schmid, Johannes Martin; Bjerrum, Anne Sofie; Skjold, Tina; Hoffmann, Hans‐Jürgen

doi:10.1111/cea.14280

Cited by 1 publication

(2 citation statements)

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“…As for many medical interventions, treatment effect will depend on precision and accuracy of the intervention 23,35 . Therefore, this study offers some practical recommendations on how to perform ILIT in allergy patients (Box 1).…”

Section: Discussionmentioning

confidence: 99%

“…As for many medical interventions, treatment effect will depend on precision and accuracy of the intervention. 23,35 Therefore, this study offers some practical recommendations on how to perform ILIT in allergy patients (Box 1). We are convinced that clinics or medical practices seeking to integrate routine ILIT applications can significantly improve injection accuracy through consistent practice and adherence to the outlined recommendations.…”

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confidence: 99%

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How to hit the allergy target: A critical appraisal of intralymphatic immunotherapy with practical recommendations on ultrasound‐guided injections

Flory,

Hviid‐Vyff,

Šošić

et al. 2024

Allergy

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BackgroundIntralymphatic immunotherapy (ILIT) represents a promising novel approach treating allergic diseases. However, no standardized procedures or recommendations have been established or reported, despite the recognized fact that treatment efficacy relies on the ability to inject the allergen intranodally.ObjectiveWe aim to provide a critical appraisal of ILIT as a method of allergen immunotherapy and to deliver practical recommendations for accurate ILIT.MethodsOne hundred and seventy‐three ILIT injections were performed in 28 (47%) women and 32 (53%) men with median age of 29 years (21–59). The injections were ultrasound‐guided and recorded for retrospective analysis with respect to injection location, needle visibility, medication release, and patient characteristics.ResultsThe results show that the correct positioning of the needle within the lymph node (LN) was most critical. If the whole length of the needle bevel was not inserted into the LN, substance backflush into the interstitium was observed. Selecting a more superficial LN and inserting the needle at a smaller angle towards the LN significantly improved needle visibility in the ultrasound. Longitudinal results showed that continuous practice significantly correlated with improved needle visibility and more accurate ILIT injections.ConclusionBased on our results and practical experience, we propose several recommendations for LN selection and the correct handling of ultrasound probe and needle. We are confident that ILIT standardization and training will be important as to meet the goals of good safety and efficacy of ILIT.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%