Feasibility and safety of EUS-guided selective portal vein embolization with a coil and cyanoacrylate in a live porcine model
| Autor: | Dong Wan Seo, Sung Koo Lee, Hyeon-Ji Kang, Tae Jun Song, Myung-Hwan Kim, Sang Soo Lee, Tae Young Park, Do Hyun Park |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
safety
medicine.medical_specialty Percutaneous medicine.medical_treatment Portal vein law.invention Embolization 03 medical and health sciences 0302 clinical medicine Embolus law medicine Radiology Nuclear Medicine and imaging EUS Hepatology business.industry Gastroenterology Blood flow digestive system diseases Electromagnetic coil Cyanoacrylate 030220 oncology & carcinogenesis Portal vein embolization Original Article 030211 gastroenterology & hepatology Radiology business feasibility portal vein |
| Zdroj: | Endoscopic Ultrasound |
| ISSN: | 2303-9027 |
| Popis: | Background and Objectives: Preoperative portal vein (PV) embolization using the percutaneous transhepatic approach has been performed in patients with hepatobiliary malignancy before extensive liver resection. The aim of this study is to evaluate the technical feasibility and initial safety of EUS-guided selective PV embolization using a coil and cyanoacrylate in a live porcine model. Methods: EUS-guided selective intrahepatic PV embolization with a coil and cyanoacrylate was performed in 9 pigs. The selected PV was punctured with 19G fine-needle aspiration (FNA) needle, and the coil was inserted under EUS-guidance. The cyanoacrylate was then immediately injected through the same FNA needle. The blood flow change in the embolized PV was evaluated using color Doppler EUS. A necropsy was performed following the 1-week observation period. Results: The success rates for the coil and cyanoacrylate delivery were 88.9% (8/9) and 87.5% (7/8), respectively. In 1 case, the coil migrated into the hepatic parenchyma. In another case, the cyanoacrylate injection failed due to early clogging in the FNA needle. There was a complete blockage of blood flow confirmed by color Doppler EUS in the embolized PV after coil and cyanoacrylate treatment. There was coil migration into the hepatic parenchyma in 1 case. There was no animal distress observed during the 1-week observation period before necropsy. The necropsy showed no evidence of damage to the intra-abdominal organs, and the selected PV was totally occluded with embolus. Conclusion: The study findings indicate EUS-guided selective PV embolization is both technically feasible and initially safe in an animal model. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|