CardioVascular and Interventional Radiology

, Volume 41, Issue 11, pp 1674–1682 | Cite as

Transarterial Bleomycin–Lipiodol Embolization (B/LE) for Symptomatic Giant Hepatic Hemangioma

  • Shahram AkhlaghpoorEmail author
  • Pooya Torkian
  • Jafar Golzarian
Clinical Investigation
Part of the following topical collections:
  1. Arterial Interventions



Large hepatic hemangiomas can cause symptoms such as pain and bleeding. No consensus currently exists on the optimal management of large and symptomatic hemangiomas. The purpose of this study was to evaluate the role of transarterial bleomycin–lipiodol embolization (B/LE) in the treatment of symptomatic large hepatic hemangioma.

Materials and Methods

We retrospectively reviewed 23 patients (29 hemangiomas) treated between July 2011 and August 2017. Transarterial B/LE was performed using 7–15 cc of Lipiodol mixed with 30–45 IU of bleomycin by standard three-way stopcocks. All patients were followed clinically and by imaging for an average of 7.5 months. Patterns of bleomycin–lipiodol distribution in the periphery of hemangiomas were categorized into four different grades. Technical success was defined as proper delivery of bleomycin–lipiodol into the hemangioma confirmed by post-embolization computed tomography. Clinical success was defined as more than 50% reduction of hemangioma volume and symptom improvement during follow-ups.


Technical success and clinical success were 100 and 73.9% (17 patients), respectively. Six patients (26.08%) experienced transient post-embolization syndrome. Significant size reduction was seen in patients with grade 4 hemangioma border coverage (P = 0.042).


Transarterial B/LE is a safe and efficient alternative for controlling symptoms related to large hemangiomas.


Transarterial bleomycin–lipiodol embolization (B/LE) Bleomycin–lipiodol Hepatic hemangioma 


Compliance with Ethical Standards

Conflicts of interest

The authors have no conflicts of interest with the subject matter of this manuscript. On behalf of all authors, the corresponding author states that there are no conflicts of interest.

Ethical Approval Statement

All procedures in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or similar ethical standards.

Informed Consent Statement

Informed consent was obtained from all participants included in the study.

Supplementary material

270_2018_2010_MOESM1_ESM.docx (138 kb)
Supplementary material 1 (DOCX 138 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Shahram Akhlaghpoor
    • 1
    Email author
  • Pooya Torkian
    • 2
  • Jafar Golzarian
    • 3
  1. 1.Pardis Noor Medical Imaging CenterTehranIran
  2. 2.School of MedicineShahid Beheshti University of Medical SciencesTehranIran
  3. 3.Department of RadiologyUniversity of MinnesotaMinneapolisUSA

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