Portal vein embolization with ethylene-vinyl alcohol copolymer for contralateral lobe hypertrophy before liver resection: safety, feasibility and initial experience.
Ethylene vinyl alcohol copolymer
Onyx®
Portal vein embolization (PVE)
future liver remnant (FLR)
hepatectomy
liver cancer
Journal
Quantitative imaging in medicine and surgery
ISSN: 2223-4292
Titre abrégé: Quant Imaging Med Surg
Pays: China
ID NLM: 101577942
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
entrez:
3
2
2021
pubmed:
4
2
2021
medline:
4
2
2021
Statut:
ppublish
Résumé
To report our preliminary experience with preoperative portal vein embolization (PVE) using liquid ethylene vinyl alcohol (EVOH) copolymer. Retrospectively review of patients with primary or secondary liver malignancies scheduled for extensive hepatectomy after the induction of future liver remnant (FLR) hypertrophy by right or left PVE with EVOH as the only embolic agent between 2014 and 2018 at two academic centers. Cross-sectional imaging liver volumetry data obtained before and 3-6 weeks after PVE were used to assess the FLR volume (FLRV) increase, degree of FLR hypertrophy and the FLR kinetic growth rate (KGR). Twenty-six patients (17 males; mean age, 58.7±11 years; range, 32-79 years) were included. The technical and clinical success rate was 100%. PVE produced adequate FLR hypertrophy in all patients. Embolization occurred in all targeted portal branches and in no non-target vessels. The %FLRV increased by 52.9%±32.5% and the degree of FLR hypertrophy was 16.7%±6.8%. The KGR was 4.4%±2.0% per week. Four patients experience minor complications after PVE which resolved with symptomatic treatment. The resection rate was 84.5%. One patient died during surgery for reasons unrelated to PVE. Preoperative PVE with EVOH copolymer is feasible, safe, and effective in inducing FLR hypertrophy.
Sections du résumé
BACKGROUND
BACKGROUND
To report our preliminary experience with preoperative portal vein embolization (PVE) using liquid ethylene vinyl alcohol (EVOH) copolymer.
METHODS
METHODS
Retrospectively review of patients with primary or secondary liver malignancies scheduled for extensive hepatectomy after the induction of future liver remnant (FLR) hypertrophy by right or left PVE with EVOH as the only embolic agent between 2014 and 2018 at two academic centers. Cross-sectional imaging liver volumetry data obtained before and 3-6 weeks after PVE were used to assess the FLR volume (FLRV) increase, degree of FLR hypertrophy and the FLR kinetic growth rate (KGR).
RESULTS
RESULTS
Twenty-six patients (17 males; mean age, 58.7±11 years; range, 32-79 years) were included. The technical and clinical success rate was 100%. PVE produced adequate FLR hypertrophy in all patients. Embolization occurred in all targeted portal branches and in no non-target vessels. The %FLRV increased by 52.9%±32.5% and the degree of FLR hypertrophy was 16.7%±6.8%. The KGR was 4.4%±2.0% per week. Four patients experience minor complications after PVE which resolved with symptomatic treatment. The resection rate was 84.5%. One patient died during surgery for reasons unrelated to PVE.
CONCLUSIONS
CONCLUSIONS
Preoperative PVE with EVOH copolymer is feasible, safe, and effective in inducing FLR hypertrophy.
Identifiants
pubmed: 33532278
doi: 10.21037/qims-20-808
pii: qims-11-02-797
pmc: PMC7779926
doi:
Types de publication
Journal Article
Langues
eng
Pagination
797-809Informations de copyright
2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims-20-808). RL serves as a Deputy Editor for Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare.
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