[Interventional therapy for hemangioendothelioma of the liver in a newborn infant using a central venous approach].
We report on a newborn (birth weight 3600 g) with high-output cardiac failure due to a large hepatic hemangioendothelioma requiring mechanical ventilation. One day post-partum therapy with steroids, furosemide, and digitalis was initiated. Despite this, the clinical condition deteriorated. Therefore, selective coil-embolization of the arterial vessels supplying the hemangioendothelioma was performed using a venous approach with passage to the arterial side via the ductus arteriosus. After the embolization the patient improved quickly and he was extubated 4 days postinterventionally. Follow-up sonography 4 months postinterventionally showed dramatic regression of the hepatic tumor. We conclude that the coil-occlusion of hepatic hemangioendothelioma should be performed early in symptomatic newborns as arterial puncture and its associated complications can be avoided by using a venous approach with passage to the arterial side via the ductus arteriosus. In addition, in this age group, access to the portal system can be gained through the umbilical vein to occlude portal venous supplies to the hepatic hemangioendothelioma.
Peuster
M
M
Abteilung Kinderheilkunde III und Pädiatrische Kardiologie Medizinische Hochschule Hannover.
Windhagen-Mahnert
B
B
Fink
C
C
Kardorff
R
R
Fuchs
J
J
Hausdorf
G
G
D002405:Catheterization, Central Venous / Q000295:instrumentation*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004867:Equipment Design; D005500:Follow-Up Studies; D006390:Hemangioendothelioma / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D011859:Radiography; D016896:Treatment Outcome
Interventionelle Therapie eines Hämangioendothelioms der Leber bei einem Neugeborenen über einen venösen Zugang.