Treatment of Kasabach‐Merritt syndrome by embolisation of a giant liver hemangioma

Transarterial embolization of giant liver hemangiomas associated with kasabach-merritt syndrome: a case report

“…If treated with corticosteroids, anticoagulants, antiplatelets, antifibrinolytics, interferon, radiation, or new antiangiogenic factors, the time to reach an acceptable hematological response has been reported to range from a few days to months, definitely longer than if compared to embolization, and not without complications (11,12,14). In our two patients, platelets and fibrin values rose to safe levels within 24 hours after embolization, similar to that reported in other published case reports (3,19). In addition, embolization provides a minimally invasive treatment option, since the severe coagulation disorders in this condition render these patients poor surgical candidates.…”

“…Symptomatic giant liver hemangiomas frequently need embolization with or without surgical resection (20). Kasabach-Merritt syndrome (KMS) is a rare and severe coagulation disorder caused by vascular malformations within or outside the liver (3,5,7). Its incidence is not known, since published papers only present case reports.…”

“…Transarterial embolization (TAE) has been applied at several centers as a minimally invasive treatment option for hemangiomas causing KMS (3,17). Noninvasive control of this severe, life-threatening coagulation disorder is essential, since these patients are poor surgical candidates.…”

“…Noninvasive control of this severe, life-threatening coagulation disorder is essential, since these patients are poor surgical candidates. Most reports on embolization treatment for KMS include various causative vascular anomalies, notably superficial angiomatous lesions with arteriovenous shunting in both infancy and adulthood, with few long-term results (3,17,19).…”

Quality of life can be improved by surgical management of giant hepatic haemangioma with enucleation as the preferred option

“…However, large haemangiomas can produce a variety of symptoms, including abdominal, shoulder and back pain, nausea, vomiting, jaundice, abdominal distension and dyspnoea. In addition, thrombocytopoenia, fever and compression of adjacent structures, rupture and consumptive coagulopathy (Kasabach–Merritt syndrome) have been reported …”