Abstract No. 325: Portal vein embolization: spectrum of embolic agents with illustrated examples

Abstract

Review the different embolic agents that are commonly used for PVE and discuss their follow up, potential complications and controversies. Portal vein embolization (PVE) is a technique of embolization used in the preoperative management of patients selected for major hepatic resection. PVE involves the occlusion of portal branches of liver parenchyma that will be resected while preserving portal branches of the intended liver remnant. Hypertrophy of the future liver remnant is expected to occur within four to six weeks thus reducing the complication rate after liver resection. Almost all embolic materials, alone and in combination, have been described for PVE. They can be divided into: 1. Coils and vascular plugs, characterized by proximal portal branch occlusion; 2. Particles and gelforam, characterized by distal portal branch embolization; 3. Liquid agents (NBCA glue, onyx or alcohol) characterized by inflammatory reaction around the portal vein. Illustrative cases of each embolic agent will be discussed as well as their result. 1PVE is an effective treatment in the management of patients selected for major hepatic resection.2Knowledge of the different embolic materials and their behavior is important for procedural success and safety.3There is no clear evidence on which embolic agent is safest.