title: Radioembolization: Is Prophylactic Embolization of Hepaticoenteric Arteries Necessary? A Systematic Review.
abstract: OBJECTIVE
  To study the effectiveness of prophylactic embolization of hepaticoenteric arteries to prevent gastrointestinal complications during radioembolization.
  
  
  METHODS
  A PubMed, Embase and Cochrane literature search was performed. We included studies assessing both a group of patients with and without embolization.
  
  
  RESULTS
  Our search revealed 1401 articles of which title and abstract were screened. Finally, eight studies were included investigating 1237 patients. Of these patients, 456 received embolization of one or more arteries. No difference was seen in the incidence of gastrointestinal complications in patients with prophylactic embolization of the gastroduodenal artery (GDA), right gastric artery (RGA), cystic artery (CA) or hepatic falciform artery (HFA) compared to patients without embolization. Few complications were reported when microspheres were injected distal to the origin of these arteries or when reversed flow of the GDA was present. A high risk of confounding by indication was present because of the non-randomized nature of the included studies.
  
  
  CONCLUSIONS
  It is advisable to restrict embolization to those hepaticoenteric arteries that originate distally or close to the injection site of microspheres. There is no conclusive evidence that embolization of hepaticoenteric arteries influences the risk of complications.
authors.affiliation: Division of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Alicia S
authors.initials: AS
authors.lastname: Borggreve
authors.affiliation: Division of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Anadeijda J E M C
authors.initials: AJEMC
authors.lastname: Landman
authors.affiliation: Division of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Coco M J
authors.initials: CMJ
authors.lastname: Vissers
authors.affiliation: Division of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Charlotte D
authors.initials: CD
authors.lastname: De Jong
authors.affiliation: Division of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Marnix G E H
authors.initials: MGEH
authors.lastname: Lam
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands.
authors.forename: Evelyn M
authors.initials: EM
authors.lastname: Monninkhof
authors.affiliation: Division of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. jipfprince@gmail.com.
authors.forename: Jip F
authors.initials: JF
authors.lastname: Prince
mesh_terms: D001918:Brachytherapy / Q000009:adverse effects*; D004064:Digestive System / Q000098:blood supply*; D004386:Duodenum / Q000098:blood supply; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005704:Gallbladder / Q000098:blood supply; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000517:prevention & control*; D006499:Hepatic Artery; D006801:Humans; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008863:Microspheres; D013270:Stomach / Q000098:blood supply
keywords: Complications; Cystic artery; Embolization; Gastroduodenal artery; Hepatic falciform artery; Radioembolization; Right gastric artery; Yttrium