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Tytuł:
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Percutaneous Portal Vein Embolization Using a Simplified Sheathless 18-Gauge Trocar Needle Approach: Review of Efficacy and Safety.
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Autorzy:
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Wong SS; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Yuen BT; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Lee RK; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Tsai CS; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Cheung YS; Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Lee KF; Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Yu SCH; Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong. Electronic address: .
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Źródło:
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Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2019 Mar; Vol. 30 (3), pp. 440-444.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Reston, Va. : Society of Cardiovascular and Interventional Radiology, c1990-
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MeSH Terms:
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Portal Vein*
Bile Duct Neoplasms/*therapy
Carcinoma, Hepatocellular/*therapy
Cholangiocarcinoma/*therapy
Embolization, Therapeutic/*methods
Enbucrilate/*administration & dosage
Ethiodized Oil/*administration & dosage
Liver Neoplasms/*therapy
Aged ; Angiography, Digital Subtraction ; Bile Duct Neoplasms/diagnostic imaging ; Bile Duct Neoplasms/pathology ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/pathology ; Cholangiocarcinoma/diagnostic imaging ; Cholangiocarcinoma/pathology ; Colorectal Neoplasms/pathology ; Computed Tomography Angiography ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/instrumentation ; Enbucrilate/adverse effects ; Equipment Design ; Ethiodized Oil/adverse effects ; Feasibility Studies ; Female ; Humans ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/pathology ; Liver Neoplasms/secondary ; Liver Regeneration ; Male ; Middle Aged ; Needles ; Portography/methods ; Punctures ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome
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Substance Nomenclature:
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8008-53-5 (Ethiodized Oil)
F8CEP82QNP (Enbucrilate)
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Entry Date(s):
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Date Created: 20190302 Date Completed: 20190506 Latest Revision: 20190506
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Update Code:
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20240105
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DOI:
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10.1016/j.jvir.2018.09.006
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PMID:
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30819490
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Purpose: Portal vein (PV) embolization (PVE) is traditionally performed via a PV sheath with selective embolization of PV branches. Here, the efficacy and safety of PVE with the use of only an 18-gauge needle is reported.
Materials and Methods: Consecutive patients who underwent PVE from 2009 through 2017 were retrospectively reviewed. Forty-five patients (mean age, 60 y ± 7.6; 38 men) underwent 45 PVE procedures. Hepatocellular carcinoma, cholangiocarcinoma, and metastases accounted for 26 (58%), 13 (29%), and 6 (13%) patients, respectively. PVE was performed by puncturing a branch of right PV with an 18-gauge needle under US guidance. Via the same needle, direct portography was performed, followed by PVE with an N-butyl cyanoacrylate/Lipiodol mixture. Percentage increase of future liver remnant (FLR) volume and increase in ratio of FLR to total liver volume were estimated as measures of efficacy. Complications were reported according to Society of Interventional Radiology classification. Fluoroscopy time, procedure time, and dose-area product (DAP) were recorded.
Results: Technical success rate was 100%. The median DAP, fluoroscopy time, and procedure time were 74,387 mGy·cm 2 (IQR, 90,349 mGy·cm 2 ), 3.5 min (IQR, 2.10 min), and 24 min (IQR, 10.5 min). Among the 23 patients with complete CT volumetry data, mean increase in the ratio of FLR to total liver volume and percentage increase of FLR volume were 12.5% ± 7.7 and 50% ± 33, respectively. There were 3 minor complications (asymptomatic nonocclusive emboli in FLR) and 3 major complications (1 hepatic vein emboli, 1 subphrenic collection, and 1 hepatic infarct).
Conclusions: PVE via a sheathless 18-gauge needle approach is feasible, with satisfactory FLR hypertrophy.
(Copyright © 2019. Published by Elsevier Inc.)
