Safety and efficacy of preoperative portal vein embolization with polyvinyl alcohol in 58 patients with liver metastases.
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.


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.


CONCLUSIONS
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.
Covey
Anne M
AM
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. coveya@mskcc.org
Tuorto
Scott
S
Brody
Lynn A
LA
Sofocleous
Constantinos T
CT
Schubert
Johanna
J
von Tengg-Kobligk
Hendrik
H
Getrajdman
George I
GI
Schwartz
Lawrence H
LH
Fong
Yuman
Y
Brown
Karen T
KT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D011169:Portal Vein; D011300:Preoperative Care; D015641:Radiography, Interventional; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D011142:Polyvinyl Alcohol