[Portal vein embolization using the amplatzer vascular plug II: preliminary results].
OBJECTIVE
In this study we examined the feasibility of portal vein embolization (PVE) by using the Amplatzer Vascular Plug (AVP-II). We measured the time of vessel occlusion after plug deployment and changes in plug length and diameter within 4 weeks of PVE.


METHODS
In 10 consecutive patients (4 women, age 64 +/- 10 yrs, 48 - 82 yrs) an ipsilateral PVE of the right portal vein was performed prior to intended hemihepatectomy. After embolization with microparticles, the right portal vein was occluded using an AVP-II. We measured the time of complete vessel occlusion by angiography. Follow-up with computed tomography (CT) was performed within 72 h and after 4 weeks.


RESULTS
PVE was performed in all 10 patients without acute complications. Complete vessel occlusion was achieved in 9.7 +/- 5.1 min (range 1 - 21 min). On follow-up CT we found enhanced arterial vascularization of the embolized liver segments in 5 / 5 patients within 72 hours and in 6 / 10 patients after 4 weeks. The plug showed a contraction of 20 +/- 9 % and a dilatation of 23 +/- 13 %. Thus, the AVP-II dilated to 94 +/- 8 % (78 - 100 %) of its nominal diameter. The plug diameter was significantly larger in men compared to women (17 +/- 1.7 mm vs. 14 +/- 1.4 mm, p < 0.02). We did not observe any recanalization or migration of the device. The volume of the left liver lobe increased significantly by 27 % (p < 0.001) after 4 weeks.


CONCLUSIONS
PVE with the AVP-II is a feasible and effective method. The AVP-II can dilate within 4 weeks up to its nominal diameter dependent on the grade of oversizing. Dilatation of the diameter is associated with a shortening in length.
Libicher
M
M
Institut und Poliklinik für Radiologische Diagnostik, Klinikum der Universität zu Köln. martin.libicher@uk-koeln.de
Herbrik
M
M
Stippel
D
D
Poggenborg
J
J
Bovenschulte
H
H
Schwabe
H
H
D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery*; D004106:Dilatation; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy; D006500:Hepatic Duct, Common; D006801:Humans; D018285:Klatskin Tumor / Q000601:surgery*; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D011300:Preoperative Care; D012189:Retrospective Studies; D055989:Septal Occluder Device; D012737:Sex Factors; D014057:Tomography, X-Ray Computed