Ces radiol. 2007, 61(2):167-172

Embolization of liver hemangiomasOriginal article

Vlastimil Válek¹, Jaroslav Boudný¹, JiříTomášek², Petr Kysela³

¹ Radiologická klinika LF MU a FN, Brno

² Oddělení klinické onkologie FN, Brno

³ Chirurgická klinika LF MU a FN, Brno

Aim: To review the possibilities of selective/superselective embolization in subjects with large, painful liver hemangiomas and to evaluate own results from the perspective of literature data.

Method: Thirteen subjects with a large cavernous liver hemangioma (greater than 4 cm) underwent its embolization between 1996 and 2005. All subjects complained of right upper quadrant pain or discomfort. All subjects underwent ultrasound examination together with CT/MRI before treatment. The indication for treatment was governed by multidisciplinary indication committee. Liver function including hepatic extraction fraction (HIDA) was routinely evaluated. Otherwise, the preparation was similar to any other vascular intervention. Embolization was performed using Seldinger technique via right femoral vein to the branch of hepatic artery. Embolization material consisted of oily contrast agent (Lipiodol Ultra-fluide, Guerbet) and non-ionic iodinated contrast agent Iomeron 300 (Iomeprol, Bracco International). Additionaly, gelatinous foam (Curaspon, Curaspon Healthcare) was used in four cases; in one case of Kasabach-Merritt syndrome, Lipiodol embolization was combined with platinum microspirals insertion (Tornado, COOK).

Results: Single embolization procedure was performed in 10 subjects, embolization was repeated in three cases (3 to 7 months), three embolization sessions were utilized in the patient with Kasabach-Merritt syndrome. After six months post treatment, hemangioma reduced its size by 20 % or more in nine patients, by 40 % or more in five patients. No severe complication was encountered in the study group. Temporary worsening of liver functions was observed in eight subjects.

Conclusion: Embolization of symptomatic large liver hemangiomas is an effective therapeutical option with minimal complication rate; compared to surgical treatment, its morbidity and mortality are negligible.

Keywords: embolization, hemangioma, liver, Lipiodol

Accepted: April 15, 2007; Published: June 1, 2007  Show citation