Department of Radiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
Turk J Med Sci. 2021 Dec 13;51(6):2943-2950. doi: 10.3906/sag-2102-352.
BACKGROUND/AIM: Treatment of hepatic hemangiomas is a controversial topic, and traditional treatment is surgical excision. Transcatheter arterial embolisation (TAE) and transcatheter arterial chemoembolisation (TACE) have been reported as minimally invasive treatment methods. To the best of our knowledge, there are no studies comparing use of TACE and TAE for hepatic hemangioma treatment. The aim of the study is to compare symptom resolution, size reducing effects, and complications of TACE and TAE for the treatment of giant hepatic hemangiomas.
A total of 104 patients underwent TACE using bleomycin, and 108 patients underwent TAE. The patients were followed-up for 2 year and follow-up images at 6 months, 12 months, and 24 months were acquired. Lesion volumes in both follow-up images were calculated. The patients were examined for any possible procedure related complications as well as the status of their initial symptoms.
The shrinkage period was determined to have ended after 12. month in both groups. The results of the two-way mixed ANOVA showed that there was significant main effect of procedure type (p ≤ 0.001) on hemangioma volumes. Similarly, there was a significant interaction between procedure and time (p ≤ 0.001).
Both methods are effective in symptomatic relief in properly selected patients. However, TACE causes greater volume reduction with less pain and, therefore, is the better endovascular treatment option.
背景/目的：肝血管瘤的治疗是一个有争议的话题，传统的治疗方法是手术切除。经导管动脉栓塞术（TAE）和经导管动脉化疗栓塞术（TACE）已被报道为微创治疗方法。据我们所知，目前尚无比较 TACE 和 TAE 治疗肝血管瘤的研究。本研究旨在比较 TACE 和 TAE 治疗巨大肝血管瘤的症状缓解、缩瘤效果和并发症。
共 104 例患者接受博来霉素 TACE 治疗，108 例患者接受 TAE 治疗。患者随访 2 年，分别在 6 个月、12 个月和 24 个月时进行随访，并获取随访图像。计算两组随访图像中的病灶体积。检查患者是否有任何可能与手术相关的并发症以及初始症状的情况。
两组的缩瘤期均在 12 个月时确定结束。双向混合方差分析的结果显示，治疗方法类型对血管瘤体积有显著的主要影响（p≤0.001）。同样，治疗方法和时间之间存在显著的交互作用（p≤0.001）。
两种方法在适当选择的患者中均能有效缓解症状。然而，TACE 引起的疼痛更小，体积减少更多，因此是更好的血管内治疗选择。
