title: Percutaneous transhepatic portal embolization using foam ethanolamine oleate and carbon dioxide (CO₂): a pilot study.
abstract: BACKGROUND
  Percutaneous transhepatic portal embolization (PTPE) can induce atrophy of the embolized- and hypertrophy of the residual area. These effects are advantageous in patients scheduled for extended hepatectomy.
  
  
  OBJECTIVE
  To evaluate the clinical safety and effectiveness of foam sclerotherapy with foam ethanolamine oleate (EO) and carbon dioxide (CO2) for PTPE before hepatectomy.
  
  
  METHODS
  We performed sclerotherapy for PTPE in 15 patients with: hepatocellular carcinoma (HHC; n = 9), bile duct carcinoma (n = 5), or metastatic liver tumor from colon cancer (n = 1). The foam contained 5% EO iopamidol (EOI) and CO2 at a 1:2 ratio. We compared the percentage of the pre- and post-PTPE future liver remnant (FLR) volumes and calculated the percent FLR volume (%FLR) increase after PTPE.
  
  
  RESULTS
  The amount of EOI used (range, 14-20 mL; median, 16.8 mL) was based on the volume of the target portal vein. Technical success was achieved in 14 of 15 patients (93%); the other patient presented with computed tomography evidence of recanalization 1 week after PTPE. The FLR volume before and after portal vein embolization was 599 ± 342 and 691 ± 318 cm(3), respectively (P < 0.01); the mean %FLR volume increase was 29.5%. There was no significant difference in the mean platelet count, total bilirubin, total aspartate aminotransferase, and total creatinine before and after PTPE. One patient suffered intra-abdominal bleeding that required transcatheter arterial embolization. No other patients developed major complications higher than grade 3.
  
  
  CONCLUSIONS
  Sclerotherapy using foam EOI and CO2 is clinically safe and effective for PTPE before hepatectomy.
authors.affiliation: Department of Diagnostic Radiology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Seijiro
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Department of Diagnostic Radiology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan osamu-3643ik@do9.enjoy.ne.jp.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ikeda
authors.affiliation: Department of Diagnostic Radiology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nakasone
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.affiliation: Department of Diagnostic Radiology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Yokoyama
authors.affiliation: Department of Diagnostic Radiology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Utsunomiya
authors.affiliation: Department of Gastroenterological Surgery, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
authors.affiliation: Department of Diagnostic Radiology, Kumamoto University Graduate School of Life Sciences, Kumamoto, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D021721:Balloon Occlusion; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D002245:Carbon Dioxide / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009829:Oleic Acids / Q000627:therapeutic use*; D010865:Pilot Projects; D011169:Portal Vein; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D009829:Oleic Acids; D012597:Sclerosing Solutions; D002245:Carbon Dioxide; C033343:ethanolamine oleate
keywords: Vascular; adult; angiography; embolization; vein