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Transcatheter Arterial Embolization with Bleomycin-Lipiodol of Hepatic Hemangiomas: Safety, Efficacy and Predictors of Response

  • Clinical Investigation
  • Embolisation (arterial)
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the safety, efficacy and predictors of response of transcatheter arterial embolization (TAE) to treat hepatic hemangiomas (HHs).

Materials and Methods

A retrospective analysis was conducted of consecutive HH patients who received TAE with bleomycin-Lipiodol emulsion and gelatin sponge particles at three institutions from January 2014 to January 2021. TAE effectiveness was defined as more than 50% reduction of tumor volume. The effectiveness, safety, and CT changes of hemangiomas after TAE were assessed. Factors affecting TAE efficacy on tumor size were analyzed with logistic regression analysis.

Results

A total of 102 patients with 109 HHs were included. After treatment, both the tumor diameter and volume were significantly reduced from 8.5 ± 3.9 to 5.9 ± 3.8 cm (P < 0.001) and 412.6 ± 742.3 cm3 to 102.0 ± 232.7 cm3 (P < 0.001), respectively. TAE effectiveness was achieved in 80.7% (88/109) of hemangiomas, which was characterized by progressive reduction in tumor volume over time with Lipiodol retention. Atypical enhancement pattern (tiny enhancing dots in the hepatic arterial and portal venous phase) (p = 0.001) and central arterioportal shunt (APS) (p = 0.002) associated with the tumor were independent predictors of TAE ineffectiveness. Postembolization syndrome and transient increase in liver enzymes were common without severe complications and death.

Conclusion

TAE was safe and effective in reducing HH size. Lesion enhancement pattern and APS type were associated with TAE efficacy on tumor shrinkage.

Level of Evidence

Level 3, non-controlled retrospective cohort study.

Graphical Abstract

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Funding

Key Scientific and Technological Projects of Changjiang Navigation Administration, 202210005, Lingli Xie.

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Author notes

  1. Dan Zhao and Lingli Xie have contributed equally to this work and are co-first authors.

Authors and Affiliations

  1. Department of Radiology, Hubei Province Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, China

    Dan Zhao, Joyman Makamure, Ziyi Liu, Lijie Zhang, Qing Li, Xin Zhang, Chuansheng Zheng & Bin Liang

  2. Department of Gastroenterology, General Hospital of the Yangtze River Shipping, No. 1 Huiji Road, Wuhan, 430010, China

    Lingli Xie

  3. Department of Radiology, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, 410008, China

    Yazhuo Zhao & Liangrong Shi

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  1. Dan Zhao
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Correspondence to Liangrong Shi or Bin Liang.

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Zhao, D., Xie, L., Makamure, J. et al. Transcatheter Arterial Embolization with Bleomycin-Lipiodol of Hepatic Hemangiomas: Safety, Efficacy and Predictors of Response. Cardiovasc Intervent Radiol (2024). https://doi.org/10.1007/s00270-024-03690-4

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