Seijiro Inoue 1 , Osamu Ikeda 2 , Yutaka Nakasone 1 , Toru Beppu 3 , Toshiro Masuda 3 , Koichi Yokoyama 1 , Daisuke Utsunomiya 1 , Hideo Baba 3 , Yasuyuki Yamashita 1 Show Affiliations »
Abstract
BACKGROUND: Percutaneous transhepatic portal embolization (PTPE) can induce atrophy of the embolized- and hypertrophy of the residual area. These effects are advantageous in patients scheduled for extended hepatectomy. PURPOSE: To evaluate the clinical safety and effectiveness of foam sclerotherapy with foam ethanolamine oleate (EO) and carbon dioxide (CO2) for PTPE before hepatectomy. MATERIAL AND METHODS: We performed sclerotherapy for PTPE in 15 patients with: hepatocellular carcinoma (HHC; n = 9), bile duct carcinoma (n = 5), or metastatic liver tumor from colon cancer (n = 1). The foam contained 5% EO iopamidol (EOI) and CO2 at a 1:2 ratio. We compared the percentage of the pre- and post-PTPE future liver remnant (FLR) volumes and calculated the percent FLR volume (%FLR) increase after PTPE. RESULTS: The amount of EOI used (range, 14-20 mL; median, 16.8 mL) was based on the volume of the target portal vein. Technical success was achieved in 14 of 15 patients (93%); the other patient presented with computed tomography evidence of recanalization 1 week after PTPE. The FLR volume before and after portal vein embolization was 599 ± 342 and 691 ± 318 cm(3), respectively (P < 0.01); the mean %FLR volume increase was 29.5%. There was no significant difference in the mean platelet count, total bilirubin, total aspartate aminotransferase, and total creatinine before and after PTPE. One patient suffered intra-abdominal bleeding that required transcatheter arterial embolization. No other patients developed major complications higher than grade 3. CONCLUSION: Sclerotherapy using foam EOI and CO2 is clinically safe and effective for PTPE before hepatectomy. © The Foundation Acta Radiologica 2015.
BACKGROUND: Percutaneous transhepatic portal embolization (PTPE) can induce atrophy of the embolized- and hypertrophy of the residual area. These effects are advantageous in patients scheduled for extended hepatectomy. PURPOSE: To evaluate the clinical safety and effectiveness of foam sclerotherapy with foam ethanolamine oleate (EO ) and carbon dioxide (CO2 ) for PTPE before hepatectomy. MATERIAL AND METHODS: We performed sclerotherapy for PTPE in 15 patients with: hepatocellular carcinoma (HHC ; n = 9), bile duct carcinoma (n = 5), or metastatic liver tumor from colon cancer (n = 1). The foam contained 5% EO iopamidol (EOI ) and CO2 at a 1:2 ratio. We compared the percentage of the pre- and post-PTPE future liver remnant (FLR) volumes and calculated the percent FLR volume (%FLR) increase after PTPE. RESULTS: The amount of EOI used (range, 14-20 mL; median, 16.8 mL) was based on the volume of the target portal vein. Technical success was achieved in 14 of 15 patients (93%); the other patient presented with computed tomography evidence of recanalization 1 week after PTPE. The FLR volume before and after portal vein embolization was 599 ± 342 and 691 ± 318 cm(3), respectively (P < 0.01); the mean %FLR volume increase was 29.5%. There was no significant difference in the mean platelet count, total bilirubin , total aspartate aminotransferase, and total creatinine before and after PTPE. One patient suffered intra-abdominal bleeding that required transcatheter arterial embolization. No other patients developed major complications higher than grade 3. CONCLUSION: Sclerotherapy using foam EOI and CO2 is clinically safe and effective for PTPE before hepatectomy. © The Foundation Acta Radiologica 2015.
Entities: Chemical
Disease
Species
Keywords:
Vascular; adult; angiography; embolization; vein
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Year: 2015
PMID： 26113740 DOI： 10.1177/0284185115590285
Source DB: PubMed Journal: Acta Radiol ISSN： 0284-1851 Impact factor: 1.990