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Systemic embolism in an infant following haemangioma embolization: a two-step process
Paul G Firth1, Mohammed I Ahmed
1Department of Anesthesia, Tufts Medical School, New England Medical Center, Boston, MA 02111, USA. pfirth@partners.org
Paediatric Anaesthesia
|October 11, 2003
Summary
Therapeutic embolization for a liver hamartoma led to pulmonary embolism and death in a newborn. This rare complication may be due to newborn shunts and tumor vascularity, causing systemic embolization.
Area of Science:
- Pediatric Interventional Radiology
- Neonatal Cardiology
- Vascular Tumor Management
Background:
- Therapeutic embolization is a treatment for hypervascular liver tumors.
- Neonates present unique challenges in interventional procedures due to physiological differences.
Observation:
- A term infant underwent embolization for a hypervascular liver hamartoma.
- During the procedure, signs of pulmonary embolism were observed.
Findings:
- The infant subsequently died from myocardial ischemia.
- Systemic embolization of embolic material is suspected as the cause of death.
- Intrathoracic shunts and tumor-related vascular changes likely contributed to the systemic embolization.
Implications:
- Highlights the potential risk of systemic embolization during embolization in neonates.
- Emphasizes the need for careful consideration of patient-specific anatomy and physiology.
- Suggests a need for enhanced vigilance and potentially modified techniques in neonatal interventional radiology.
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