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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 11/2018

01-11-2018 | Clinical Investigation

Transarterial Bleomycin–Lipiodol Embolization (B/LE) for Symptomatic Giant Hepatic Hemangioma

Authors: Shahram Akhlaghpoor, Pooya Torkian, Jafar Golzarian

Published in: CardioVascular and Interventional Radiology | Issue 11/2018

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Abstract

Background

Large hepatic hemangiomas can cause symptoms such as pain and bleeding. No consensus currently exists on the optimal management of large and symptomatic hemangiomas. The purpose of this study was to evaluate the role of transarterial bleomycin–lipiodol embolization (B/LE) in the treatment of symptomatic large hepatic hemangioma.

Materials and Methods

We retrospectively reviewed 23 patients (29 hemangiomas) treated between July 2011 and August 2017. Transarterial B/LE was performed using 7–15 cc of Lipiodol mixed with 30–45 IU of bleomycin by standard three-way stopcocks. All patients were followed clinically and by imaging for an average of 7.5 months. Patterns of bleomycin–lipiodol distribution in the periphery of hemangiomas were categorized into four different grades. Technical success was defined as proper delivery of bleomycin–lipiodol into the hemangioma confirmed by post-embolization computed tomography. Clinical success was defined as more than 50% reduction of hemangioma volume and symptom improvement during follow-ups.

Results

Technical success and clinical success were 100 and 73.9% (17 patients), respectively. Six patients (26.08%) experienced transient post-embolization syndrome. Significant size reduction was seen in patients with grade 4 hemangioma border coverage (P = 0.042).

Conclusion

Transarterial B/LE is a safe and efficient alternative for controlling symptoms related to large hemangiomas.
Appendix
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Metadata
Title
Transarterial Bleomycin–Lipiodol Embolization (B/LE) for Symptomatic Giant Hepatic Hemangioma
Authors
Shahram Akhlaghpoor
Pooya Torkian
Jafar Golzarian
Publication date
01-11-2018
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 11/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-018-2010-4

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