Role of Hepatic Artery Embolization in Giant Hemangioma of Liver

Introduction: Endovascular management in the form of transarterial embolization (TAE) is offered in cases of symptomatic hemangiomas, unresectable hemangiomas, preoperatively, in diffuse hemangiomatosis, in progressively growing hemangiomas, and those at a high risk of bleeding. Recent studies have shown that TAE is a safe and effective treatment option for lesions that are large and located peculiarly on inferior surface of liver and high risk of rupture. Purpose: The purpose is to study the radiological features of giant haemangioma on various modalities, to assess the safety, feasibility, and efficacy of TAE of hepatic artery in giant liver haemangioma, and to evaluate post-procedural complications and follow-up (FU) examinations to look for success of embolization. Materials and Methods: It is a prospective retrospective study conducted in Radiodiagnosis Department of GMCH, Nagpur. All giant hemangiomas detected on ultrasonography, computed tomography, or magnetic resonance imaging in symptomatic patients and already diagnosed cases presenting with recurrence/relapse and complicated giant hemangiomas were included in the study. Exclusion criteria were hemangiomas <4 cm in size and general contraindications to angiography, intolerance of contrast media, and peripheral vascular disease. Results: The study revealed significant reduction in the size of lesion (P < 0.0001 – highly significant [HS]) at 3and 9-month FU, respectively, in the right lobe of liver and (P < 0.0105 – significant [S] at 3-month FU and P < 0.0032 HS at 9-month FU) the left lobe of liver. Conclusions: TAE in giant hepatic hemangiomas is safe, feasible, efficient, minimally invasive with good patient acceptance, with minimal complications, and no mortality. Hence, transcatheter arterial embolization should be performed in the management of giant hepatic hemangiomas.