Management of Kasabach–Merritt Phenomenon With Transarterial Embolization in Patients With Kaposiform Hemangioendothelioma

Abstract

Objectives: The aim of this study is to demonstrate, through a series of four cases, that endovascular approach through transarterial embolization is a useful adjunctive tool and rapid method to reduce tumoral blood flow supply in patients with Kaposiform hemangioendothelioma (KHE) who present with Kasabach–Merritt phenomenon (KMP). Methods: We reviewed clinical records of four patients from January 2019 to December 2019 in Unidad Médica de Alta Especialidad Hospital de Pediatría in Centro Médico Nacional de Occidente with clinical diagnosis of KHE who presented with KMP. Patients were treated with transarterial embolization and followed from the time of diagnosis through 6 months following endovascular procedure. Results: Serum hemoglobin and platelet counts improved within 48 hours following embolization and were sustained for at least 6 months. Tumors notably decreased in size and improved in color in 3 of 4 patients. Conclusions: Transarterial embolization in this group of patients showed a rapid increase in the platelet count, which can be traduced as a good adjunctive treatment for patients that have a slow improvement in platelet count receiving standard medical treatment alone.