Percutaneous Portal Vein Embolization Using a Simplified Sheathless 18-Gauge Trocar Needle Approach: Review of Efficacy and Safety
| Autor: | Ryan Ka-lok Lee, Simon C.H. Yu, Brian T.Y. Yuen, Chris Siu Chun Tsai, Simon Sin Man Wong, Yue Sun Cheung, Kit Fai Lee |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Percutaneous Carcinoma Hepatocellular Time Factors Computed Tomography Angiography medicine.medical_treatment Punctures Cholangiocarcinoma Ethiodized Oil Risk Factors medicine Fluoroscopy Humans Radiology Nuclear Medicine and imaging Embolization Vein Portography Aged Retrospective Studies medicine.diagnostic_test business.industry Portal Vein Liver Neoplasms Angiography Digital Subtraction Interventional radiology Equipment Design Enbucrilate Middle Aged Embolization Therapeutic Liver Regeneration medicine.anatomical_structure Treatment Outcome Bile Duct Neoplasms Needles Angiography Lipiodol Feasibility Studies Female Cardiology and Cardiovascular Medicine Nuclear medicine business Colorectal Neoplasms medicine.drug |
| Zdroj: | Journal of vascular and interventional radiology : JVIR. 30(3) |
| ISSN: | 1535-7732 |
| Popis: | 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·cm2 (IQR, 90,349 mGy·cm2), 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. |
| Databáze: | OpenAIRE |
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