title: Assessing Intra-arterial Complications of Planning and Treatment Angiograms for Y-90 Radioembolization.
abstract: OBJECTIVE
  To report hepatic arterial-related complications encountered during planning and treatment angiograms for radioembolization and understand any potential-associated risk factors.
  
  
  METHODS
  518 mapping or treatment angiograms for 180 patients with primary or metastatic disease to the liver treated by Yttrium-90 radioembolization between 2/2010 and 12/2015 were retrospectively reviewed. Intra-procedural complications were recorded per SIR guidelines. Patient demographics, indication for treatment, prior exposure to chemotherapeutic agents, operator experience, and disease burden were reviewed. Technical variables including type of radioembolic (glass vs. resin microspheres), indication for angiography (mapping vs. treatment), variant anatomy, and attempts at coil embolization were also assessed.
  
  
  RESULTS
  Thirteen (13/518, 2.5%) arterial-related complications occurred in 13 patients. All but two complications resulted during transcatheter coil embolization to prevent non-target embolization. Complications included coil migration (n = 6), arterial dissection (n = 2), focal vessel perforation (n = 2), arterial thrombus (n = 2), and vasospasm prohibiting further arterial sub-selection (n = 1). Transarterial coiling was identified as a significant risk factor of complications on both univariate and multivariate regression analysis (odds ratio 7.8, P = 0.004). Usage of resin microspheres was also a significant risk factor (odds ratio 9.5, P = 0.042). No other technical parameters or pre-procedural variables were significant after adjusting for confounding on multivariate analysis (P > 0.05).
  
  
  CONCLUSIONS
  Intra-procedural hepatic arterial complications encountered during radioembolization were infrequent but occurred mainly during coil embolization to prevent non-target delivery to extra-hepatic arteries.
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Rush University Medical Center, 1725 W. Harrison Street, Suite 450, Chicago, IL, 60612, USA. osman1423@gmail.com.
authors.forename: Osman
authors.identifier: http://orcid.org/0000-0003-2440-2437
authors.initials: O
authors.lastname: Ahmed
authors.affiliation: Department of Radiology, University of Chicago, Chicago, IL, 60637, USA.
authors.forename: Mikin V
authors.initials: MV
authors.lastname: Patel
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Rush University Medical Center, 1725 W. Harrison Street, Suite 450, Chicago, IL, 60612, USA.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Masrani
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Rush University Medical Center, 1725 W. Harrison Street, Suite 450, Chicago, IL, 60612, USA.
authors.forename: Bradford
authors.initials: B
authors.lastname: Chong
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Rush University Medical Center, 1725 W. Harrison Street, Suite 450, Chicago, IL, 60612, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Osman
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Rush University Medical Center, 1725 W. Harrison Street, Suite 450, Chicago, IL, 60612, USA.
authors.forename: Jordan
authors.initials: J
authors.lastname: Tasse
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Rush University Medical Center, 1725 W. Harrison Street, Suite 450, Chicago, IL, 60612, USA.
authors.forename: Jayesh
authors.initials: J
authors.lastname: Soni
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Rush University Medical Center, 1725 W. Harrison Street, Suite 450, Chicago, IL, 60612, USA.
authors.forename: Ulku Cenk
authors.initials: UC
authors.lastname: Turba
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Rush University Medical Center, 1725 W. Harrison Street, Suite 450, Chicago, IL, 60612, USA.
authors.forename: Bulent
authors.initials: B
authors.lastname: Arslan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D015021:Yttrium Radioisotopes
keywords: Arterial complication; Complication; Radioembolization; Selective internal radiation therapy