Transarterial chemoembolization with bleomycin and lipiodol: a novel treatment for giant hepatic haemangiomas

Giant hepatic haemangiomas are among the most common benign liver tumours, with an incidence ranging from 4.0% to 20.0%. Large hepatic haemangiomas can cause symptoms such as pain and bleeding. There is currently no gold standard in their treatment. One of the methods is transarterial bleomycin-lipiodol embolisation (B/LE). The aim of this study is to evaluate the efficacy of treating hepatic haemangiomas with B/LE.

We retrospectively reviewed 44 patients treated with B/LE between February 2021 and June 2022 in the Department of Interventional Radiology and Neuroradiology, Medical University of Lublin. Before the procedure, all patients were examined by magnetic resonance imaging (MRI) or computed tomography. Vascularised lesions were embolised by intraarterial administration of a mixture of bleomycin and lipiodol, closing the vascularisation of the lesion, which was confirmed by control angiography. All patients were followed up clinically and by MRI for an average of 6 months.

The size of the examined haemangiomas before the procedure ranged from 5 to 16 cm. After the first procedure, 28 out of 44 patients had an essential reduction in the size of the haemangioma, while 16 patients had the procedure repeated. Eventually, the size of the haemangiomas decreased significantly (p ≤ 0.05). The average reduction in volume was 67.22%. Technical success, described as the reduction of blood supply to the haemangioma, was achieved in all the cases.

Transarterial B/LE is an effective procedure resulting in reduced size of haemangiomas and alleviation of symptoms.