title: Permanent transarterial embolization of neuroendocrine metastases of the liver using cyanoacrylate and lipiodol: assessment of mid- and long-term results.
abstract: OBJECTIVE
  The purpose of our study was to assess the results of hepatic artery embolization using N-butyl-2-cyanoacrylate and ethiodized oil for the treatment of small-bowel neuroendocrine metastases to the liver as part of a multimodality protocol for the treatment of liver metastases from neuroendocrine small-bowel tumors.
  
  
  METHODS
  Twenty-three patients underwent permanent embolization of the hepatic artery using cyanoacrylate and Lipiodol for treatment of liver metastases after radical resection of small-bowel neuroendocrine tumors. All patients received additional treatment including somatostatin, and most patients received interferon as well. Cumulative survival rates were estimated using the Kaplan-Meier method.
  
  
  RESULTS
  Overall, 75 embolizations (range, 1-10; mean, 3.3) were performed. Median survival time was 69 months, and the estimated cumulative survival rates reached 95.7% and 65.4% for 1 and 5 years, respectively. Two deaths (8.7%) occurred within 1 month of treatment, and one patient experienced a vascular complication at the time of embolization.
  
  
  CONCLUSIONS
  Permanent embolization of hepatic arteries as part of a multimodality treatment protocol is beneficial in long-term follow-up for patients with metastasized small-bowel neuroendocrine tumors. The use of cyanoacrylate as an embolic agent is safe and effective.
authors.affiliation: Department of Radiology, Division of Angiography and Interventional Radiology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Loewe
authors.forename: Martin
authors.initials: M
authors.lastname: Schindl
authors.forename: Manfred
authors.initials: M
authors.lastname: Cejna
authors.forename: Bruno
authors.initials: B
authors.lastname: Niederle
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.forename: Siegfried
authors.initials: S
authors.lastname: Thurnher
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries; D016461:Chemoembolization, Therapeutic / Q000379:methods; D003487:Cyanoacrylates / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D003487:Cyanoacrylates; D007459:Iodized Oil