Liver hypertrophy after percutaneous portal vein embolization: comparison of N-butyl-2-cyanocrylate versus sodium acrylate-vinyl alcohol copolymer particles in a swine model.
OBJECTIVE
Percutaneous portal vein embolization (PPVE) induces hypertrophy of the future liver remnant before hepatic resection. The ideal embolic material has not yet been determined. We compared N-butyl-2-cyanocrylate (NBCA) with sodium acrylate-vinyl alcohol copolymer particles using a swine model.


METHODS
Twelve pigs underwent PPVE. Six pigs (group A) were embolized with NBCA, and 6 pigs (group B) were embolized with sodium acrylate-vinyl alcohol copolymer particles. Computed tomographic volumetry of the embolized lobe (EL) and the nonembolized lobe (NEL), along with liver function tests, was performed before and at 14 and 28 days after embolization. Tissue samples from both lobes were taken 14 and 28 days after PPVE.


RESULTS
NEL-volume and NEL-ratio increases were significantly higher in group A at 14 and 28 days after PPVE (78 and 52% and 91 and 66%, respectively) than in group B (32 and 12% and 28 and 10%, respectively) (p < 0.05). Percent change of the EL-volume was significantly higher for group A at 28 days after PPVE. No statistically significant difference was found between the groups regarding hepatocyte proliferation on the NEL and apoptosis on the EL at both time intervals.


CONCLUSIONS
PPVE using NBCA is more efficient and causes more NEL hypertrophy than microspheres.
2nd Department of Radiology, Medical School, General University Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, Greece. gtsoumakidou@yahoo.com
Georgia
G
Tsoumakidou
Stamatis
S
Theocharis
Nikolaos
N
Ptohis
Efthimia
E
Alexopoulou
George
G
Mantziaras
Nikolaos L
NL
Kelekis
Elias N
EN
Brountzos
D000180:Acrylic Resins / Q000008:administration & dosage*; D015901:Angiography, Digital Subtraction; D000818:Animals; D004621:Embolization, Therapeutic; D004659:Enbucrilate / Q000008:administration & dosage*; D006984:Hypertrophy; D008099:Liver / Q000098:blood supply / Q000473:pathology*; D008297:Male; D008863:Microspheres; D011145:Polyvinyls / Q000008:administration & dosage*; D011169:Portal Vein / Q000000981:diagnostic imaging; D034421:Sus scrofa; D014014:Tissue Adhesives / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed
D000180:Acrylic Resins; D011145:Polyvinyls; D014014:Tissue Adhesives; C569390:acrylic acid-vinyl alcohol copolymer; D004659:Enbucrilate