2:34 PM Abstract No. 42 - Comparison of three portal vein embolization strategies

Abstract

Purpose Portal vein embolization (PVE) is considered a safe and effective method for inducing selective hepatic hypertrophy of the future liver remnant (FLR) in patients being prepared for partial hepatectomy, and reducing the incidence of post-operative hepatic failure. Several different embolic agents have been used successfully for PVE. Our aim was to compare our hypertrophy results using three different embolization strategies Materials and Methods This is a retrospective study for all the portal vein embolization procedures performed in our academic medical centre from the period of 2004 until 2012. Over this time period the preferred embolization technique evolved, from initially using only PVA particles, to then using PVA and coils, and later using only NBCA glue. All procedures were performed by experienced IRs according to an institutional protocol. The groups were sequential in time, with no overlap. Pre- and post-procedure CT were assessed. (GE AW server 2, Version AWS 2.0-5.0,) Volumetric reconstruction software was used to measure the total liver volumes (TLV) and future liver remnant (FLR) volumes pre and post embolization. Results A total of 100 patients underwent portal vein embolization. Three groups were identified in our data: 23 patients treated with particles, 59 patients with particles and coils and 18 with glue. There was no statistical significance among the three embolization strategies in terms of degree of FLR hypertrophy. A mean of 43 % difference between the pre and post embolization FLR volume was achieved in the particles group (95% CI is 24% to 62%). In the particles plus coils group the mean difference was 52% (95% CI is 37% to 67%), and in the glue group the mean was 54% (95% CI is 32 to 82%). Conclusion PVE using glue showed a slight higher degree of hypertrophy compared to using particles plus coils or particles alone, although the difference between these groups was not statistically significant.