Management of High Hepatopulmonary Shunts in the Setting of Y90 Radioembolization.

Treatment paradigms for primary and metastatic malignancies involving the liver have evolved in recent years to include targeted liver therapies. Transarterial radioembolization is at the forefront of therapy in many treatment algorithms. However, due to significant hepatopulmonary shunting, some patients are excluded from this proven treatment due to the possibility of radiation-induced lung injury. In this article, we review techniques to mitigate hepatopulmonary shunts to improve the likelihood of inclusion and successful treatment in these patients.