Ultrasonography-guided percutaneous microwave ablation for large hepatic cavernous haemangiomas

To evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) for large hepatic cavernous haemangiomas (HCHs) with ablation of the feeding artery and aspiration of blood from haemangioma simultaneously.

From January 2011 to December 2016, 40 patients (29 females, 11male; average age 43.25 ± 7.65 years) with 42 giant hepatic haemangiomas (mean diameter 7.02 ± 1.55 cm, range 4.1-10.8 cm) were treated with image-guided percutaneous MWA with ablation of the feeding artery and aspiration of blood from haemangioma simultaneously. After MWA, therapeutic efficacy was assessed by contrast-enhanced imaging during follow-up. Median follow-up time was 24 months (range 6-60 months).

Technical effectiveness rate was 100% with a mean ablation time of 1175 ± 516 (range 480-2340) seconds. The mean number of antenna insertions was 3.82 ± 1.23 for each lesion. Clinical effectiveness rate was 95% (38/40). There was a significant decrease of the tumour volume within three days after ablation compared with before ablation (p < 0.001). The mean tumour volume shrinkage rate was 59.67 ± 16.73% (range 28.20-89.72%) within three days after ablation. Minor complications mainly included fever, transient elevation of transaminase, pleura effusion, and haemoglobinuria. One patient developed a major complication with acute kidney injury (AKI) shortly after MWA, whose renal function gradually recovered after haemodialysis. No other severe complications occurred in perioperative and follow-up periods.

Ultrasound-guided percutaneous MWA for large HCHs with ablation of the feeding artery and aspiration of blood from haemangioma simultaneously is safe and effective.