Transarterial Bleomycin–Lipiodol Chemoembolization for the Treatment of Giant Hepatic Hemangiomas: An Assessment of Effectiveness

Abstract

This study evaluates the effectiveness of superselective transcatheter arterial chemoembolization (TACE) using a bleomycin–lipiodol emulsion in treating giant hepatic hemangiomas. A retrospective review included 31 patients with a mean age of 53 ± 10.42 years who underwent TACE from December 2014 to October 2022, with follow-up imaging examinations to assess outcomes. Technical success was defined as successful embolization of all feeding arteries, and clinical success was defined as a reduction in hemangioma volume by 50% or more on follow-up imaging. This study observed a 100% technical success rate. Post-embolization syndrome was common, and two cases of asymptomatic hepatic artery dissection were noted. Clinical success was achieved in 80.6% of patients, with significant volume reduction observed in the majority. Conclusively, superselective transcatheter arterial chemoembolization with bleomycin–lipiodol emulsions is presented as a viable and effective treatment option for giant hepatic hemangiomas. With no procedure-related mortality and significant volume reduction in most cases, this method offers a promising alternative to surgical intervention. This study’s findings suggest a need for further exploration and validation in larger-scale prospective studies.

Hepatic Hemangioma: Review of Imaging and Therapeutic Strategies

“…Transcatheter arterial chemoembolization (TACE) has recently gained traction as an effective treatment for hepatic hemangiomas. The efficacy of TACE has been extensively reviewed [ 6 , 88 , 89 , 93 , 116 ]. Bleomycin is known for its cytotoxic, antiangiogenic, and sclerosing properties, leading to DNA degradation and eliciting a generalized inflammatory response in the vicinity of the lesion and the portal area [ 117 ].…”

“…Despite the growing application of these methods, consensus regarding the efficacy of TAE in treating hemangiomas and the spectrum of potential complications remains elusive [ 74 , 83 , 84 , 85 , 86 , 87 , 88 ]. Liu et al reported that TACE employing pingyangmycin yielded unsatisfactory outcomes in liver hemangioma treatments, highlighting a considerable risk of severe complications [ 85 ].…”