Hepatic Artery Embolization

Hepatic artery embolization (HAE) is a minimally invasive, image-guided procedure used by interventional radiologists at Stanford Pediatric Radiology to treat various pediatric liver conditions. This technique involves using a catheter to selectively block blood flow to a specific area of the liver with embolic agents. In children, HAE is a valuable tool for controlling active bleeding from liver trauma and can be used for chemoembolization to treat liver tumors like hepatoblastoma and hepatocellular carcinoma. Stanford's pediatric expertise ensures these procedures are adapted for the unique needs of young patients, providing safe and effective care.

Example case: A pre-school aged child with low platelets suffered a delayed hemorrhage after percutaneous liver biopsy.

Post-biopsy day 4: Increasing ascites and difficulty ventilating
- CTA: extravasation in segment 3 and increased ascites with layering hyperdensity
  • Ultrasound-guided peritoneal drainage of old blood products with an additional signficant reaccumulation over the course of the procedure
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  • Hepatic arteriography and embolization:
    - Right common femoral artery access 
    - Catheter advanced into the common hepatic artery
    - Common hepatic angiogram did not show evidence of bleeding
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  • Hepatic arteriography and embolization:
    - Selective left hepatic angiogram showed bleeding from a segment 3 branch without extension to the liver capsule

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  • Gelfoam embolization of the segment 3 artery with absent filling of the branches supplying the area of injury

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