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Purpose To determine the incidence, cause, and management of microcatheter/delivery device occlusion during Yttrium-90 microsphere infusions. Materials and Methods This is a single institution retrospective chart review of 478 resin based (Sir-Sphere) microsphere treatments in 271 patients, and 378 glass based (TheraSphere) microsphere treatments in 236 patients, performed between June 2001 and October 2012 by 6 attending interventional radiologists. Infusion data collected included type of microcatheter, hepatic artery injected, whether it was the first or subsequent radioembolization, dose given, site of occlusion along the course of the delivery system, type of microsphere, and management. Results Microcatheter and/or delivery device occlusion occured in 11 out of 478 (2.3%) resin based microsphere treatments, and 1 out of 378 (0.3%) glass based microsphere treatments. We found no statistically significant trends regarding the other variables described for investigation. One case resulted in a radiation spill/reportable event, in which the full dose was not able to be given during the treatment session. In the remainder of cases, various techniques were employed to administer the full dose during the treatment session. Conclusion Microcatheter and/or delivery device occlusion is uncommon, but can occur during infusion of Y-90 microspheres. The incidence is significantly higher with administration of resin based microspheres versus glass based microspheres, perhaps in part due to the number of spheres administered. There are techniques to reduce the chances of occlusion, and when occlusion is encountered, there are techniques that may be employed to administer the full dose during the treatment setting. |
