OBJECTIVE: The objective of our study was to evaluate the safety and efficacy of transhepatic lobar portal vein embolization (PVE) using polyvinyl alcohol (PVA) particles to induce contralateral lobar hypertrophy in patients with liver-only metastases and normal underlying liver function. MATERIALS AND METHODS: Fifty-eight consecutive patients with small predicted future liver remnants (FLRs) underwent PVE with PVA particles to induce hypertrophy of the contralateral hemi-liver before surgical resection of liver metastases. Total liver, right hemi-liver, and left hemi-liver volumes were calculated before and after embolization using a 3D workstation. RESULTS: Eight patients underwent left PVE; 47, right PVE; and three, right and segment IV PVE. There were no major complications of the procedure. The mean increases in the ratio of the FLR to the total estimated liver volume after right, right and segment IV, and left PVE were 9%, 10%, and 3%, respectively; the corresponding mean hypertrophy ratios were 24.3%, 31.9%, and 1.5%, respectively. CONCLUSION: Right PVE using PVA particles alone as the embolic agent is safe and effective in achieving left hemi-liver hypertrophy. In contrast, left PVE did not induce significant right hemi-liver hypertrophy in this patient population.
OBJECTIVE: The objective of our study was to evaluate the safety and efficacy of transhepatic lobar portal vein embolization (PVE) using polyvinyl alcohol (PVA) particles to induce contralateral lobar hypertrophy in patients with liver-only metastases and normal underlying liver function. MATERIALS AND METHODS: Fifty-eight consecutive patients with small predicted future liver remnants (FLRs) underwent PVE with PVA particles to induce hypertrophy of the contralateral hemi-liver before surgical resection of liver metastases. Total liver, right hemi-liver, and left hemi-liver volumes were calculated before and after embolization using a 3D workstation. RESULTS: Eight patients underwent left PVE; 47, right PVE; and three, right and segment IV PVE. There were no major complications of the procedure. The mean increases in the ratio of the FLR to the total estimated liver volume after right, right and segment IV, and left PVE were 9%, 10%, and 3%, respectively; the corresponding mean hypertrophy ratios were 24.3%, 31.9%, and 1.5%, respectively. CONCLUSION: Right PVE using PVA particles alone as the embolic agent is safe and effective in achieving left hemi-liver hypertrophy. In contrast, left PVE did not induce significant right hemi-liver hypertrophy in this patient population.
Authors: Jing Qi; Amita Shukla-Dave; Yuman Fong; Mithat Gönen; Lawrence H Schwartz; William M Jarnagin; Jason A Koutcher; Kristen L Zakian Journal: J Magn Reson Imaging Date: 2011-08 Impact factor: 4.813
Authors: Yoji Kishi; David C Madoff; Eddie K Abdalla; Martin Palavecino; Dario Ribero; Yun Shin Chun; Jean-Nicolas Vauthey Journal: Surgery Date: 2008-08-10 Impact factor: 3.982
Authors: José Hugo Mendes Luz; Paula Mendes Luz; Tiago Bilhim; Henrique Salas Martin; Hugo Rodrigues Gouveia; Élia Coimbra; Filipe Veloso Gomes; Roberto Romulo Souza; Igor Murad Faria; Tiago Nepomuceno de Miranda Journal: Cancer Imaging Date: 2017-09-20 Impact factor: 3.909
Authors: Shimul A Shah; Alice C Wei; Sean P Cleary; Ilun Yang; Ian D McGilvray; Steven Gallinger; David R Grant; Paul D Greig Journal: J Gastrointest Surg Date: 2007-05 Impact factor: 3.267