Transcatheter arterial sclerosis and embolization with bleomycin lipiodol emulsion and polyvinyl alcohol in the treatment of infantile hepatic hemangioendothelioma

Abstract

Objective To evaluate the safety and effectivity of transcatheter arterial sclerosis and embolization (TASE) with bleomycin lipiodol emulsion and polyvinyl alcohol (PVA) in the treatment of infantile hepatic hemangioendothelioma (IHH). Methods Fortytwo children with IHH were diagnosed, including 20 males and 22 females, ranging from 26 days to 5.0 years with a median of 10 months. Celiac artery angiography under DSA was performed to conform IHH. Bleomycin lipiodol emulsion and PVA were injected to feeding arteries by super selective technique. The follow-up time was 3 to 36 months, with an average of (19±6) months. Results Total TASE was 80 times, 1 to 4 times/case;The tumor volume was reduced by about 63.4% after 3 months, and was completely disappeared in 39 cases one year later, 3 cases with diffuse lesions were reduced slightly and TASE was performed again after a year, the tumors were completely disappeared. Five cases showed slight elevation of serum aminotransferase, and recovered to be normal after symptomatic treatment. One case showed right femoral artery stenosis, and balloon dilation was performed one month later. One case had bilateral iliac artery thrombosis, and was back to be normal after anticoagulant therapy. One case had a transient pulmonary embolism, and the symptoms disappeared after 2 days with auxiliary respiratory support. Conclusion TASE with bolemicin lipiodol emulsion and PVA is a safe and effective method in the treatment of IHH. Key words: Infant; Hemangioma; Liver; Embolization, therapeutic; Bleomycin