Transarterial embolization for a congenital large hemangioma associated with severe high-output cardiac failure and Kasabach-Merritt phenomenon

A newborn boy had a dusky-red mass on his left anterior neck region and left face. The mass was hard and about 8 cm in diameter. His blood examination revealed thrombocytopenia, coagulopathy and anemia, and his chest X-ray showed cardiomegaly. The thrombocytopenia and coagulopathy with large hemangioma was diagnosed as Kasabach-Merritt phenomenon. Pharmacological and radiological treatment failed to improve his condition, and the high-output cardiac failure deteriorated to a need of continuous hemodiafiltration due to acute renal failure. Transarterial embolization with glue was performed for the congenital hemangioma on the 5th day of life. His cardiac failure as well as Kasabach- Merritt phenomenon dramatically improved after the procedure. Most hemangiomas in children regress spontaneously. However, some of them associate life-threatening high-output cardiac failure and consumptive coagulopathy. Transarterial embolization is required for a large hemangioma with such a condition.