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Preoperative portal vein embolization using an amplatzer vascular plug
Hyunkyung Yoo1, Gi-Young Ko, Dong Il Gwon
1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
European Radiology
|December 6, 2008
Summary
Preoperative portal vein embolization (PVE) using an Amplatzer vascular plug (AVP) is safe and effective. This technique successfully induced future liver remnant (FLR) hypertrophy with low recanalization rates.
Area of Science:
- Interventional Radiology
- Hepatobiliary Surgery
Background:
- Preoperative portal vein embolization (PVE) is crucial for inducing liver hypertrophy before major liver resection.
- Optimizing PVE techniques is essential for improving outcomes and minimizing complications.
Purpose of the Study:
- To evaluate the safety and efficacy of PVE using the Amplatzer vascular plug (AVP) combined with gelatin sponge particles.
- To assess technical success, complication rates, recanalization, and liver volume changes post-PVE.
Main Methods:
- Forty-one patients underwent PVE using gelatin sponge particles and AVP deployment in the right portal vein.
- Follow-up CT scans assessed total estimated liver volumes (TELV), future liver remnant (FLR), and FLR/TELV ratio.
Main Results:
- Technical success was achieved in 40 of 41 patients.
- Major complications included portal vein thrombosis and liver abscess in two patients.
- Significant increases in mean FLR volume (653 vs. 532 ml) and FLR/TELV ratio (43% vs. 36%) were observed post-PVE.
Conclusions:
- PVE with AVP is a safe and effective method for inducing FLR hypertrophy.
- The technique demonstrates a low risk of recanalization, supporting its use in clinical practice.
