title: Comparison of Clinical Outcomes following Glue versus Polyvinyl Alcohol Portal Vein Embolization for Hypertrophy of the Future Liver Remnant prior to Right Hepatectomy.
abstract: OBJECTIVE
  To report outcomes after portal vein embolization (PVE) and right hepatectomy in patients receiving embolization with N-butyl cyanoacrylate (NBCA) glue + central AMPLATZER Vascular Plug (AVP; glue group) or polyvinyl alcohol (PVA) particles ± coils (PVA group).
  
  
  METHODS
  Between March 2008 and August 2013, all patients having PVE with NBCA + AVP or PVA ± coils before right hepatectomy were retrospectively reviewed; 85 patients underwent PVE with NBCA + AVP (n = 45) or PVA ± coils (n = 40). The groups were compared using Mann-Whitney U and χ2tests.
  
  
  RESULTS
  Technical success of embolization was 100%. Degree of hypertrophy (16.2% ± 7.8 vs 12.3% ± 7.62, P = .009) and kinetic growth rate (3.5%/wk ± 2.0 vs 2.6%/wk ± 1.9, P = .016) were greater in the glue group versus the PVA group. Contrast volume (66.1 mL ± 44.8 vs 189.87 mL ± 62.6, P < .001) and fluoroscopy time (11.2 min ± 7.8 vs 23.49 min ± 11.7, P < .001) were significantly less during the PVE procedure in the glue group. Surgical outcomes were comparable between groups, including the number of patients unable to go onto surgery (P = 1.0), surgical complications (P = .30), length of hospital stay (P = .68), and intensive care unit admissions (P = .71). There was 1 major complication (hepatic abscess) in each group after PVE.
  
  
  CONCLUSIONS
  PVE performed with NBCA + AVP compared with PVA ± coils resulted in greater degree of hypertrophy of the future liver remnant, less fluoroscopic time and contrast volume, and similar complication rates.
authors.affiliation: Division of Vascular and Interventional Radiology, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada. Electronic address: arashjab@gmail.com.
authors.forename: Arash
authors.initials: A
authors.lastname: Jaberi
authors.affiliation: Department of Diagnostic Imaging , Markham Stouffville Hospital, Markham, Ontario, Canada.
authors.forename: Sundeep S
authors.initials: SS
authors.lastname: Toor
authors.affiliation: Division of Vascular and Interventional Radiology, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada.
authors.forename: Dheeraj K
authors.initials: DK
authors.lastname: Rajan
authors.affiliation: Division of Vascular and Interventional Radiology, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada.
authors.forename: Oleg
authors.initials: O
authors.lastname: Mironov
authors.affiliation: Division of Vascular and Interventional Radiology, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada.
authors.forename: John R
authors.initials: JR
authors.lastname: Kachura
authors.affiliation: Department of Medical Imaging, and Division of General Surgery, Department of Surgery, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Cleary
authors.affiliation: Department of Medical Imaging, and Division of General Surgery, Department of Surgery, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada.
authors.forename: Rory
authors.initials: R
authors.lastname: Smoot
authors.affiliation: Department of Medical Imaging, and Division of General Surgery, Department of Surgery, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada.
authors.forename: Amélie
authors.initials: A
authors.lastname: Tremblay St-Germain
authors.affiliation: Division of Vascular and Interventional Radiology, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada.
authors.forename: Kongteng
authors.initials: K
authors.lastname: Tan
mesh_terms: D000368:Aged; D049109:Cell Proliferation; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D004659:Enbucrilate / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005471:Fluoroscopy; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006984:Hypertrophy; D007902:Length of Stay; D008113:Liver Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000556:secondary / Q000601:surgery*; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011142:Polyvinyl Alcohol / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D011142:Polyvinyl Alcohol; D004659:Enbucrilate