title: Portal vein embolization before right hepatectomy or extended right hepatectomy using sodium tetradecyl sulfate foam: technique and initial results.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of portal vein embolization (PVE) with sodium tetradecyl sulfate (STS) foam.
  
  
  METHODS
  A single-center retrospective review of 35 patients (27 men and 8 women; mean age, 61 y) who underwent PVE with STS foam was performed. The technical success rate, rate of PVE at producing adequate future liver remnant (FLR) hypertrophy, and rate of disease progression precluding resection after PVE were analyzed. Complications of PVE and liver resection after PVE were recorded.
  
  
  RESULTS
  PVE was performed on 35 patients before right hepatic resection for both primary and secondary hepatic malignancies (22 hepatocellular carcinoma, 10 metastasis, 2 cholangiocarcinoma, 1 invasive gallbladder carcinoma). Technical success was achieved in 97.1% (34 of 35) of patients. Mean FLR of the total estimated liver volume increased from 24.5% (SD, 7.7%) to 36.5% (SD, 14.5%), a mean percentage increase of 48.8% (SD, 34.3%). PVE produced adequate FLR hypertrophy in 31 of 35 patients (88.6%). Proposed right hepatectomy was subsequently performed in 27 patients (77.1%). One patient remains scheduled for surgery, two had peritoneal spread at surgery and resection was aborted, two had disease progression on imaging after PVE, and three had inadequate FLR hypertrophy with no surgery. One major complication was observed related to PVE that involved nontarget embolization to segment III, which was managed conservatively.
  
  
  CONCLUSIONS
  Preoperative PVE with STS foam is a safe and effective method to induce hypertrophy of the FLR.
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1234, New York, NY 10029. Electronic address: aaron.fischman@mountsinai.org.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Fischman
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1234, New York, NY 10029.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Ward
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1234, New York, NY 10029.
authors.forename: Jeremy C
authors.initials: JC
authors.lastname: Horn
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1234, New York, NY 10029.
authors.forename: Edward
authors.initials: E
authors.lastname: Kim
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1234, New York, NY 10029.
authors.forename: Rahul S
authors.initials: RS
authors.lastname: Patel
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1234, New York, NY 10029.
authors.forename: F Scott
authors.initials: FS
authors.lastname: Nowakowski
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1234, New York, NY 10029.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Lookstein
mesh_terms: D015901:Angiography, Digital Subtraction; D049109:Cell Proliferation; D018450:Disease Progression; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D006984:Hypertrophy; D008113:Liver Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000628:therapy*; D008115:Liver Regeneration; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009519:New York City; D010690:Phlebography / Q000379:methods; D011169:Portal Vein; D012189:Retrospective Studies; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D012981:Sodium Tetradecyl Sulfate