Arterial Embolization with n-Butyl-Cyanoacrylate for a Large Gluteal Intramuscular Hemangioma: A Case Report

TL;DR

This case report shows that arterial embolization with NBCA effectively reduced a large gluteal hemangioma, offering pain relief and size reduction in a 52-year-old man.

Contribution

Demonstrates the efficacy of NBCA embolization for treating large high-flow intramuscular hemangiomas in a clinical case.

Findings

NBCA embolization significantly reduced the size of the hemangioma and alleviated the patient's symptoms.

Follow-up imaging confirmed the effectiveness of the treatment in occluding the vascular malformation.

The procedure was performed safely over multiple sessions targeting different arterial feeders.

Abstract

Background and Clinical Significance: We wished to review the use of arterial embolization with n-butyl-cyanoacrylate (NBCA) to treat large high-flow vascular malformations due to its rapid polymerization and ability to permanently occlude large and small vessels. Case Presentation: A 52-year-old male presented with a two-year history of progressively worsening pain and swelling in the right gluteal area. Imaging techniques (color Doppler ultrasonography, CT, DSA, and MRI) were utilized for the diagnosis of a large high-flow intramuscular hemangioma. The mass displaced the surrounding tissues but showed no signs of lymphadenopathy or distant metastasis. The treatment involved targeting different arterial feeders over several sessions. Each procedure used NBCA–Lipiodol under fluoroscopic guidance, progressively reducing the malformation’s size and alleviating his symptoms. After the final embolization, the patient showed significant pain relief and a reduction in the size of the malformation, confirmed by follow-up imaging, demonstrating NBCA embolization’s effectiveness. The protocol’s safety and efficacy in this context are discussed. Conclusions: Arterial embolization with NBCA is a promising treatment for large high-flow vascular malformations, providing symptom relief and reductions in lesion size. While this case report highlights the procedure’s efficacy, further research is needed for a broader understanding of its long-term outcomes and potential complications.

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