Analysis of the efficacy of superselective intravascular embolization in the treatment of large hemangioma in children / 中华放射学杂志

ABSTRACT

Objective To evaluate the clinical efficacy of superselective intravascular embolization in the treatment of large hemangiomas in children,and to provide a reliable basis for the clinical treatment and to predict prognosis.Methods The clinical and imaging data of 85 children with large hemangiomas who underwent superselective angiography and embolization were collected in our hospital from January 2015 to January 2018,and followed up for 3 months to 1.5 years.According to the DSA angiography of the hemangioma [artery origin,artery number,arterio-venous fistula(AVF)],and combined with age,tumor size and the selection and compatibility of embolization materials.Using the chi-square test to analyze these indicators.Results Analysis of the clinical efficacy indicators,was shown as the following(1) Artery originThe total effectiveness rate of single and mixed sources was 95.3％ (61/64),66.7％ (14/21) respectively.The difference was statistically significant (x2=0.688,P＜0.05).(2) Feeding artery numberThe total effectiveness rate of 1 branch,2 branches and ≥3 branches was (3/3),(25/27)and (47/55) respectively.The difference was statistically significant (x2=1.944,P＜0.05).(3) Presence of fistula(AVF)The total effectiveness rate of AVF and without AVF was 36.4％ (4/11) and (95.9％,71/74) respectively.The difference was statistically significant (x2=0.806,P＜0.05).Other influencing factors including(1)Agethe recurrence rate of patients≤5 months and＞5 months was 33.3％ (6/18) and 20.9％ (14/67)respectively.There was no significant difference (x2=1.220,P＞0.05);(2)Tumor sizeThe recurrence rate of φ≤80 mm and φ＞80 mm was 25.5％(13/51)and 32.4％(11/34) respectively.There was no significant difference (x2=0.474,P＞0.05).(3) Selection and compatibility of embolization materialsThe recurrence rate of Lipiodol + bleomycin and gelatin sponge +bleomycin was 27.0％ (10/37) and 31.3％ (15/48) respectively.There was no significant difference (x2=0.179,P＞0.05).Conclusions The clinical efficacy of superselective intravascular embolization in the treatment of large hemangioma in children was influenced byartery origin(mixed sources),artery number (≥3 branches),AVF,age tumor size,selection and compatibility of embolic materials.