Comparison of Clinical Outcomes following Glue versus Polyvinyl Alcohol Portal Vein Embolization for Hypertrophy of the Future Liver Remnant prior to Right Hepatectomy

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• 作者：Arash Jaberi ; MD ; FRCPC^a ; ^{arashjab@gmail.com} ; Sundeep S. Toor ; MD ; MSc ; FRCPC^c ; Dheeraj K. Rajan ; MD ; FRCPC ; FSIR^a ; Oleg Mironov ; MD^a ; John R. Kachura ; MD ; FRCPC ; FSIR^a ; Sean P. Cleary ; MD ; FRCPC^b ; Rory Smoot ; MD^b ; Amé ; lie Tremblay St-Germain ; MD^b ; Kongteng Tan ; MD ; FRCS ; FRCR ; FRCPC^a
• 关键词：AVP ; AMPLATZER Vascular Plug ; BSA ; body surface area ; CBD ; common bile duct ; FLR ; future liver remnant ; KGR ; kinetic growth rate ; NBCA ; N-butyl cyanoacrylate ; PVA ; polyvinyl alcohol ; PVE ; portal vein embolization ; sFLR ; standardized future liver remnant
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：27
• 期：12
• 页码：1897-1905.e1
• 全文大小：492 K
• 卷排序：27

文摘

To report outcomes after portal vein embolization (PVE) and right hepatectomy in patients receiving embolization with N-butyl cyanoacrylate (NBCA) glue + central AMPLATZER Vascular Plug (AVP; glue group) or polyvinyl alcohol (PVA) particles ± coils (PVA group).Materials and MethodsBetween March 2008 and August 2013, all patients having PVE with NBCA + AVP or PVA ± coils before right hepatectomy were retrospectively reviewed; 85 patients underwent PVE with NBCA + AVP (n = 45) or PVA ± coils (n = 40). The groups were compared using Mann-Whitney U and χ2 tests.ResultsTechnical success of embolization was 100%. Degree of hypertrophy (16.2% ± 7.8 vs 12.3% ± 7.62, P = .009) and kinetic growth rate (3.5%/wk ± 2.0 vs 2.6%/wk ± 1.9, P = .016) were greater in the glue group versus the PVA group. Contrast volume (66.1 mL ± 44.8 vs 189.87 mL ± 62.6, P < .001) and fluoroscopy time (11.2 min ± 7.8 vs 23.49 min ± 11.7, P < .001) were significantly less during the PVE procedure in the glue group. Surgical outcomes were comparable between groups, including the number of patients unable to go onto surgery (P = 1.0), surgical complications (P = .30), length of hospital stay (P = .68), and intensive care unit admissions (P = .71). There was 1 major complication (hepatic abscess) in each group after PVE.ConclusionsPVE performed with NBCA + AVP compared with PVA ± coils resulted in greater degree of hypertrophy of the future liver remnant, less fluoroscopic time and contrast volume, and similar complication rates.