Improved hypertrophy of future remnant liver after portal vein embolization with plugs, coils and particles

Cardiovasc Intervent Radiol. 2014 Oct;37(5):1251-8. doi: 10.1007/s00270-013-0810-0. Epub 2013 Dec 6.

Abstract

Purpose: To retrospectively analyze efficacy as measured by volume gain of future remnant liver (FRL) after right portal vein embolization (PVE) using particles only versus particles and additional central plug and/or coil (CP/C) embolization.

Methods: All patients who underwent PVE between July 2011 and December 2012 were retrospectively analyzed. Right PVE was performed either with particle-only (PO) embolization or additional CP/C embolization. All enrolled patients underwent computed tomography or magnetic resonance imaging before PVE and surgery. The images were used for volumetry of the FRL.

Results: Of 75 patients, 40 had PO and 35 CP/C embolization. Age, sex, and tumor entities did not differ significantly between the two groups. Tumor entities included cholangiocarcinoma (n = 52), metastasis from colorectal cancer (n = 14), hepatocellular carcinoma (n = 2), and others (n = 7). Time from PVE to preoperative imaging was similar in both groups. FRL volume before PVE was 329 ± 121 ml in the PO group and 333 ± 135 ml in the CP/C group, and 419 ± 135 ml and 492 ± 165 ml before operation. The average percentage volume gain was significantly higher in the CP/C group than in the PO group, with 53.3 ± 34.5 % versus 30.9 ± 28.8 % (p = 0.002).

Conclusion: Right PVE with additional CP/C embolization leads to a significantly higher gain in FRL volume than embolization with particles alone.

MeSH terms

  • Contrast Media
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods*
  • Female
  • Gadolinium DTPA
  • Hepatomegaly / complications
  • Hepatomegaly / diagnosis*
  • Hepatomegaly / pathology
  • Humans
  • Image Enhancement / methods
  • Liver / diagnostic imaging
  • Liver / pathology*
  • Liver / surgery*
  • Liver Neoplasms / complications
  • Liver Neoplasms / surgery*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Organ Size
  • Portal Vein
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Ultrasonography

Substances

  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA