Efficacy of Transarterial Bleomycin-Lipiodol Embolisation in Patients with Giant Hepatic Hemangioma

INTRODUCTION: This study aimed evaluate symptom resolution, size reduction and complications of transarterial chemoembolization (TACE) with Bleomycin-Lipiodol in giant liver hemangiomas.
METHODS: In this study evaluated 19 consecutive patients with giant hepatic hemangioma who underwent transarterial chemoembolization between June 2020 and May 2023. Inclusion criteria were as follows: (1) presence of a hepatic mass larger than 5 cm on dynamic cross-sectional examination with typical features of a hemangioma, (2) presence of symptoms secondary to hepatic hemangioma or compression effect of the mass on surrounding tissues, (3) TACE procedure performed in our center. Clinical success was defined as resolution of symptoms and radiologic success was defined as more than 50% reduction in giant hemangioma volume on 6 months follow-up CT or MRI compared.
RESULTS: A total of 19 patients were included in the study. The mean size of hemangiomas decreased from 9.35cm±3.5cm (5cm-16.9cm) to 5.76cm±1.52cm (3.5cm-9cm). The volume of hemangiomas before the procedure was between 27 cc-845 cc with a median value of 169 cc. After the procedure, the volumes ranged between 14 cc-182 cc with a median value of 45 cc. The changes in both size and volume before and after the procedure were found to be significant and p<0.0001. Radiological success, more than 50% reduction in volume, was achieved in sixteen patients (84.2%). Significant improvement in symptoms and other signs of compression was also achieved.
DISCUSSION AND CONCLUSION: Liver hemangioma embolisation with Bleomycin-Lipiodol is safe, reduces the size and volume of giant liver hemangiomas, and provides significant success both clinical and radiological results.