Caliber-Persistent Labial Artery

Q: Dr. Eppley, I have Caliber-Persistent Labial Artery (CPLA) in my lips with visible pulsating on middle upper lip on the right side. I am curious to know if you heard of the more conservative methods in treating CPLA? Would you be willing to try these two simple methods before doing a surgery?

A couple of doctors that have successfully treated CPLA in multiple patients by using triamcinolone (kenalog 40): “In view of the size of the lesion and concern over the functional and esthetic impairment that might result from surgery, the patient was treated with triamcinolone (40 mg/ml) injected at low pressure into the lesion, which caused the formation of deposits of colloidal particles within the lesion. The procedure was repeated twice at 2-week intervals. Subsequently, the lesion was found to have completely regressed. The favorable therapeutic results achieved”

A doctor has treated CPLA in multiple patients using high-frequency electrocautery. It is described that the successful use of a 30-gauge hypodermic needle to deliver a low-powered, high frequency electrical current from a hyfrecator. This inexpensive, simple approach was used in 8 patients.

A: I can not speak to these dermatologic approaches to CPLA as I have never done them nor would I have any confidence in their success despite what is reported. I simply do not believe they would be effective long term in a high flow lip artery. I think the only assured approach would be one of a double ligation encompassing two points to cut off the flow to it from both sides.

Dr. Barry Eppley

Indianapolis, Indiana