Reduction of arteriohepatovenous shunting by temporary balloon occlusion in patients undergoing radioembolization.
Radioembolization with yttrium-90 resin microspheres is a treatment option that selectively targets hepatic tumors. One of the primary limiting factors for this therapy is the degree of arteriohepatovenous shunting, as excessive radiation to the lungs may cause radiation pneumonitis. To safeguard patients against this, a technetium Tc 99m macroaggregated albumin scan is performed before treatment to assess the degree of arteriohepatovenous shunting. As lung shunt fraction increases, activity reductions are mandated, with a 20% shunt sufficient to prohibit treatment. Temporary occlusion of shunts may be achieved by placement of balloon catheters in the hepatic veins. This endovascular technique used to reduce arteriohepatovenous shunting allows otherwise untreatable patients to undergo radioembolization.
Bester
Lourens
L
Department of Interventional Radiology, University of New South Wales, St. Vincent's Hospital, Darlinghurst, New South Wales 2010, Australia. lourensb@bigpond.net.au
Salem
Riad
R
D021721:Balloon Occlusion / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging; D008102:Liver Circulation; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000528:radiation effects; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011652:Pulmonary Circulation; D017564:Radiation Pneumonitis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D011859:Radiography; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D015021:Yttrium Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects*
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D015021:Yttrium Radioisotopes