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As discussed, the most useful classification of vascular malformations to date is the one by and . The majority of vascular malformations can be diagnosed clinically with MRI now the gold standard to delineate the extent of the lesion or in cases where the diagnosis is in doubt.

The majorities of hemangiomas are best left alone and will regress either spontaneously or with medical treatment. Endovascular embolization can be helpful in the cases of noninvoluting hemangiomas, Kaposiform hemangioendotheliomas, and hepatic hemangioendotheliomas. This can prove to be quite challenging. The aim is not to cure but to stabilize deleterious effects such as hemorrhage and thrombocytopenia.

Endovascular embolization of high-flow malformations requires proper planning and the use of microcatheter techniques. Although alcohol may produce the best result, it should be used with extreme caution due to its local and systemic effects. Although a cure may not be possible, relief of symptoms can be achieved in the majority of patients.

Percutaneous sclerotherapy of low-flow vascular malformations can be technically straightforward, but requires pre-procedure and post-procedure planning in order to avoid serious complications.

Embolization has become one of the primary techniques for treating iatrogenic bleeding. However since by default it causes vessel occlusion, it is mostly applicable to small, less important arteries or in peripheral branches that can be readily sacrificed. Proper technique generally allows a high degree of clinical success with minimal risk. With the ongoing development of stent grafts, endovascular treatment may also become the primary means of repairing larger, more critical vessels that must remain patent.

PVE is a safe technique allowing efficient preoperative hypertrophy of the FRL in selected cases. It is recommended to perform distal embolization rather than proximal occlusion or ligation. Embolic agents producing high local inflammatory reaction induce greater hypertrophy than others do.

PVE neither improves nor worsens long-term prognosis but it allows curative resection in patients that otherwise are considered as unresectable. Nowadays, it may be frequently combined with multiple other efficient therapeutic modalities (systemic or intraarterial chemotherapy, chemoembolization, radiofrequency ablation) in order to lead more patients with malignant liver tumor to radical surgery.

Embolization has become one of the primary techniques for treating iatrogenic bleeding. However since by default it causes vessel occlusion, it is mostly applicable to small, less important arteries or in peripheral branches that can be readily sacrificed. Proper technique generally allows a high degree of clinical success with minimal risk. With the ongoing development of stent grafts, endovascular treatment may also become the primary means of repairing larger, more critical vessels that must remain patent.

Current management strategies for neuroendocrine tumor hepatic metastases have relied on data from anecdotal evidence and retrospective studies involving small numbers of patients. It is unlikely that this situation will change in the near future, since prospective studies are difficult to perform in such a relatively rare and biologically heterogeneous disease. Embolotherapy is a widely accepted method of treatment for nonresectable hepatic metastases from neuroendocrine tumors. Long-term palliation of pain and hormonal symptoms is possible using repeated treatment. Both bland hepatic artery embolization and chemoembolization have been used, and there is no conclusive data to indicate which embolization method and which embolic agents are most efficacious.

Several questions remain unanswered, such as which is the best embolization agent, which is the best chemotherapeutic drug, or how can we increase the intratumoral concentration of the drug. The lack of large prospective randomized trials and the current difficulty in conducting meta-analyses on hepatic oncology embolotherapy, along with the absence of effective systemic therapy for unresectable primary and metastatic liver disease, urge intense efforts and the continuation of research on oncology embolotherapy. New developments in drug regimens, embolization materials and new variations in the embolization technique are rapidly changing the image of oncology embolotherapy and hopefully, will positively influence the outcome of treatment and patient survival.

The interventional radiologist should also bear in mind that successful embolotherapy depends on factors beyond the embolic agent selection, or the choice chemotherapeutic cocktail. Technical skills, experience, familiarity with the underlying pathologic processes, and appreciation of the importance for constructive collaboration with other specialties, are also essential for every successful oncology embolotherapy treatment.

Embolization has become one of the primary techniques for treating iatrogenic bleeding. However since by default it causes vessel occlusion, it is mostly applicable to small, less important arteries or in peripheral branches that can be readily sacrificed. Proper technique generally allows a high degree of clinical success with minimal risk. With the ongoing development of stent grafts, endovascular treatment may also become the primary means of repairing larger, more critical vessels that must remain patent.

PVE is a safe technique allowing efficient preoperative hypertrophy of the FRL in selected cases. It is recommended to perform distal embolization rather than proximal occlusion or ligation. Embolic agents producing high local inflammatory reaction induce greater hypertrophy than others do.

PVE neither improves nor worsens long-term prognosis but it allows curative resection in patients that otherwise are considered as unresectable. Nowadays, it may be frequently combined with multiple other efficient therapeutic modalities (systemic or intraarterial chemotherapy, chemoembolization, radiofrequency ablation) in order to lead more patients with malignant liver tumor to radical surgery.

EVTA should be considered a scientifically acceptable option to eliminate truncal reflux. The procedures can be performed without sedation in an ambulatory setting and are very effective, safe and associated with virtually immediate recovery. EVTA appears to be associated with a lower rate of recurrent SVI due to a virtual absence of the high rate of groin neovascularity seen with high ligation and stripping of the GSV. EVTA procedures have already begun to supplant traditional surgery for truncal incompetence.

Current management strategies for neuroendocrine tumor hepatic metastases have relied on data from anecdotal evidence and retrospective studies involving small numbers of patients. It is unlikely that this situation will change in the near future, since prospective studies are difficult to perform in such a relatively rare and biologically heterogeneous disease. Embolotherapy is a widely accepted method of treatment for nonresectable hepatic metastases from neuroendocrine tumors. Long-term palliation of pain and hormonal symptoms is possible using repeated treatment. Both bland hepatic artery embolization and chemoembolization have been used, and there is no conclusive data to indicate which embolization method and which embolic agents are most efficacious.