Combined Transarterial Sclerotherapy and Embolization with Systemic Chemotherapy Followed by Everolimus in Kaposiform Hemangioendothelioma with Kasabach-Merritt Syndrome

Spinal Kaposiform Hemangioendotheliomas: Is There a Role for Endovascular Treatment?

“…The optimal therapy is still unknown, and although complete surgical excision is considered curative, extensive intramedullary injuries may be difficult to resect due to the risk of hemorrhage [1]. The endovascular treatment of vascular spinal lesions has potential to reduce the intraoperative bleeding, shrink the lesion, and avoid mass effect [4, 5]. However, the feeding arteries of KHE are usually numerous and thin, thus embolization may be difficult [3].…”

“…However, the feeding arteries of KHE are usually numerous and thin, thus embolization may be difficult [3]. The targeted therapy with the mTOR inhibitor (such as sirolimus and everolimus) may have better results than traditional vincristine, and adjunct embolization seems to induce faster resolution of Kasabach-Merritt syndrome [1, 5]. Endovascular treatment is a valuable tool to improve outcomes and quality of life, therefore multidisciplinary treatment is encouraged [1, 2, 4].…”