Transarterial Bleomycin–Lipiodol Embolization (B/LE) for Symptomatic Giant Hepatic Hemangioma
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Large hepatic hemangiomas can cause symptoms such as pain and bleeding. No consensus currently exists on the optimal management of large and symptomatic hemangiomas. The purpose of this study was to evaluate the role of transarterial bleomycin–lipiodol embolization (B/LE) in the treatment of symptomatic large hepatic hemangioma.
Materials and Methods
We retrospectively reviewed 23 patients (29 hemangiomas) treated between July 2011 and August 2017. Transarterial B/LE was performed using 7–15 cc of Lipiodol mixed with 30–45 IU of bleomycin by standard three-way stopcocks. All patients were followed clinically and by imaging for an average of 7.5 months. Patterns of bleomycin–lipiodol distribution in the periphery of hemangiomas were categorized into four different grades. Technical success was defined as proper delivery of bleomycin–lipiodol into the hemangioma confirmed by post-embolization computed tomography. Clinical success was defined as more than 50% reduction of hemangioma volume and symptom improvement during follow-ups.
Technical success and clinical success were 100 and 73.9% (17 patients), respectively. Six patients (26.08%) experienced transient post-embolization syndrome. Significant size reduction was seen in patients with grade 4 hemangioma border coverage (P = 0.042).
Transarterial B/LE is a safe and efficient alternative for controlling symptoms related to large hemangiomas.
KeywordsTransarterial bleomycin–lipiodol embolization (B/LE) Bleomycin–lipiodol Hepatic hemangioma
Compliance with Ethical Standards
Conflicts of interest
The authors have no conflicts of interest with the subject matter of this manuscript. On behalf of all authors, the corresponding author states that there are no conflicts of interest.
Ethical Approval Statement
All procedures in studies involving human participants were performed 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 similar ethical standards.
Informed Consent Statement
Informed consent was obtained from all participants included in the study.
- 28.Favoulet P, Cercueil JP, Faure P, Osmak L, Isambert N, Beltramo JL, et al. Increased cytotoxicity and stability of Lipiodol-pirarubicin emulsion compared to classical doxorubicin–Lipiodol: potential advantage for chemoembolization of unresectable hepatocellular carcinoma. Anticancer Drugs. 2001;12(10):801–6.CrossRefGoogle Scholar