Embolisation of hepatic haemangioma causing heart failure in a 9-day-old neonate via femoral access: a rare interventional radiology case

Abstract A 9-day-old neonate, born at 37 + 5 weeks’ gestation with an antenatal diagnosis of multifocal hepatic haemangiomas (HH), presented with progressive congestive heart failure. Imaging confirmed highly vascular liver lesions with arteriovenous shunting. Following a multidisciplinary review and failed propranolol therapy, vascular redistribution embolisation was performed via femoral arterial access. Partial selective embolisation of hepatic arterial branches used microcoils and a vascular plug, preserving overall hepatic perfusion. The procedure was well tolerated with no complications and led to clinical improvement. This case illustrates the feasibility and safety of performing complex vascular interventions in neonates, highlighting the evolving role of interventional radiology in managing life-threatening complications of congenital hepatic haemangiomas (CHH), and offering an alternative when medical therapy is unsuccessful.