Embolización Transarterial frente a Escleroterapia Percutánea en Pacientes con Malformación Venosa Hepática: Una...

To find the aggregated efficacy and safety profiles of transarterial embolization (TAE) and percutaneous sclerotherapy (PS) in patients with hepatic venous malformations (HVMs).

A comprehensive search encompassing PubMed, Scopus, and Web-of-Science databases was undertaken to identify original articles reporting on the safety or efficacy of TAE or PS in adult patients with HVMs up to March 2025. Effect sizes for continuous outcomes were assessed using mean difference (MD) and ratio of means (ROM), while proportions for dichotomous outcomes were pooled using logit transformation. We used the random effect model for meta-analysis in R software.

Thirty-seven observations from 35 studies (n=2,592 patients; mean age 45.3 years; 64.5% female) were included, with 29 evaluating TAE and 8 assessing PS. Both TAE and PS significantly reduced lesion volume (TAE MD=193.20 cc, ROM=2.29 vs. PS MD=455.91 cc, ROM=3.73) and diameter (TAE MD=4.15 cm, ROM=1.81 vs. PS MD=4.04 cm, ROM=1.72). The indirect comparison showed no statistically significant difference between the two interventions for either volume (P=0.097) or diameter (P=0.72) reduction after the procedure. Clinical response rate was 86.3% in TAE and 85.9% in PS (P=0.89). Major adverse events were low and comparable (TAE=3.8% vs. PS=3.0%). TAE had higher rates of liver enzyme elevation (44.9%), while PS had no reported cases. TAE was associated with longer hospital stays (mean 1.19 days vs. near-zero for PS) and higher costs ($2,424 vs. $893, P<0.0001).

Both techniques are equally effective, but PS is associated with fewer post procedural liver enzyme derangement, shorter hospitalization, and reduced cost.