Hepatic artery ligation for hepatic hemangiomatosis of infancy

Capillary and cavernous hemangiomas of the skin and subcutaneous tissue, usually follow a benign course with enlargement in the first year of life followed by gradual involution. Hemangiomas of the liver, on the other hand, can be responsible for life threatening complications in infancy. The presence of major intrahepatic arteriovenous communications may produce a high output cardiac failure, refractory to intensive medical therapy. Use of radiation therapy and high doses of steroids have proven to be of limited success with a 90% mortality in infants managed with nonoperative therapy. Hepatic artery ligation in such patients may provide dramatic control of the high output failure, with negligible side effects. Two infants are reported in whom bilateral hepatic artery ligation provided prompt control of fulminant congestive failure secondary to hepatic hemangiomatosis, after failure of medical therapy.