Radiofrequency ablation for severe hemangiomas with thrombocytopenia and coagulation abnormalities (Kasabach-Merritt phenomenon).

Background: Kasabach-Merritt phenomenon (KMP), a potentially fatal complication of hemangiomas, necessitates effective therapeutic interventions. This study aimed to evaluate the efficacy of radiofrequency ablation (RFA) in managing severe hemangiomas with KMP, characterized by thrombocytopenia and coagulation abnormalities. While RFA emerges as a promising therapeutic option, its efficacy in pediatric KMP patients warrants further investigation. Methods: This retrospective analysis included 35 pediatric patients diagnosed with KMP who were treated at the Department of Hemangioma Surgery, The Third Affiliated Hospital of Zhengzhou University between March 2018 and September 2024. All patients underwent RFA under general anesthesia, with color Doppler ultrasound continuously monitoring the precise, multi-layer, multi-point ablation procedure. Results: In all 35 patients (15 males, 20 females; age range: 1 day-6 months; median age: 8 days), postoperative normalization of platelet counts was observed. Lesions exhibited initial hardening within 7 days but subsequently returned to normal after 2 weeks of dressing changes. During the follow-up period ranging from 6 to 24 months, complete ablation of all lesions was achieved, tumors resolved entirely, no recurrence was detected, and local function, anatomy, and aesthetics were well preserved. Conclusions: RFA demonstrates as a minimally invasive, safe, and effective therapeutic approach for KMP, associated with a low complication rate. It significantly improves survival rates and quality of life in pediatric patients, positioning itself as a highly promising therapeutic option for broader clinical application.