title: Safety and efficacy of preoperative portal vein embolization with polyvinyl alcohol in 58 patients with liver metastases.
abstract: 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.
authors.affiliation: Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. coveya@mskcc.org
authors.forename: Anne M
authors.initials: AM
authors.lastname: Covey
authors.forename: Scott
authors.initials: S
authors.lastname: Tuorto
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Brody
authors.forename: Constantinos T
authors.initials: CT
authors.lastname: Sofocleous
authors.forename: Johanna
authors.initials: J
authors.lastname: Schubert
authors.forename: Hendrik
authors.initials: H
authors.lastname: von Tengg-Kobligk
authors.forename: George I
authors.initials: GI
authors.lastname: Getrajdman
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Schwartz
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
authors.forename: Karen T
authors.initials: KT
authors.lastname: Brown
mesh_terms: 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
chemical_list: D011142:Polyvinyl Alcohol