Early- and intermediate-term outcome of transarterial embolization for symptomatic hepatic focal nodular hyperplasia

Purpose: To evaluate the early- and intermediate-term outcome in patients with symptomatic hepatic focal nodular hyperplasia (FNH) treated with transarterial embolization using bleomycin-iodinated oil and polyvinyl alcohol (PVA) particles. Materials and methods: In this two-center retrospective study between January 2005 and December 2013, 27 consecutive patients with symptomatic hepatic FNH underwent superselective catheterization by microcatheter techniques and embolization using bleomycin-iodinated oil combined with PVA. Early-term (3-41 months) follow-up of TAE was performed in terms of symptom control, changes in lesion size, and complications. Intermediate-term (45-112 months) follow-up was carried out to assess symptom control and reinterventions for recurrence. Results: Embolization was performed in 27 patients with 31 lesions. Technical success was achieved in all cases. The follow-up period ranged from three to 112 months. At early-term follow-up, mean lesion diameters were decreased significantly from 6.4±2.7 cm pre-intervention to 3.6±1.8 cm at 3-9 months after embolization (P<0.001). A total of 7 lesions had complete resolution during the whole follow-up period. At intermediate-term follow-up, local recurrence was found in 1 treated lesion at 54-months. Contrast-enhanced scans showed complete lack of residual arterial blood supply in the majority of lesions during the follow-up period. There was no major complication associated with the procedure. Conclusion: Transarterial embolization using bleomycin-iodinated oil and PVA is a feasible, safe and effective alternative in both early- and intermediate-terms for the treatment of symptomatic hepatic FNH.