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World Journal of Surgery
Published in: World Journal of Surgery 11/2017

01-11-2017 | Original Scientific Report

Superselective Transarterial Chemoembolization as an Alternative to Surgery in Symptomatic/Enlarging Liver Hemangiomas

Authors: İlgin Özden, Arzu Poyanlı, Yılmaz Önal, Ali Aslan Demir, Gültekin Hoş, Bülent Acunaş

Published in: World Journal of Surgery | Issue 11/2017

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Abstract

Background

Transarterial embolization of liver hemangiomas has not been considered to be consistently effective.

Methods

The charts of 25 patients who underwent superselective transarterial chemoembolization with the bleomycin–lipiodol emulsion were evaluated retrospectively.

Results

Twenty-two patients had abdominal pain; asymptomatic/vaguely symptomatic enlargement was the treatment indication in three patients. A single session was conducted in 17 patients, two sessions in 7 and three sessions in one. After the first session, lesion volume decreased by median (range) 51% (10–92%) from median (range) 634 (226–8435) to 372(28–4710) cm3 (p < 0.01), after a median period of 4 months (range 2–8). A second session was performed in eight patients (median (range) initial volume 1276 (441–8435) cm3) with persistent complaints and/or large lesions receiving feeders from both right and left hepatic arteries (staged treatment). Median (range) lesion size decreased further from 806 (245–4710) to 464 (159–2150) cm3 (p < 0.01). Three patients experienced a postembolization syndrome that persisted after the first week. Seventeen of the 22 symptomatic patients (77%) reported resolution or marked amelioration of complaints. Regrowth after initial regression was not observed during median (range) 14 (8–39) months of follow-up (n:18).

Conclusion

Transarterial chemoembolization with the bleomycin–lipiodol emulsion is a potential alternative to surgery for symptomatic/enlarging liver hemangiomas. Volume reduction is universal, and symptom control is satisfactory. Centrally located and very large (>1000 cm3) lesions may require two sessions.
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Metadata
Title
Superselective Transarterial Chemoembolization as an Alternative to Surgery in Symptomatic/Enlarging Liver Hemangiomas
Authors
İlgin Özden
Arzu Poyanlı
Yılmaz Önal
Ali Aslan Demir
Gültekin Hoş
Bülent Acunaş
Publication date
01-11-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 11/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-4069-5

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