Portal vein embolization using an adapted hysterosalpingography catheter

Area of Science:

• Interventional Radiology
• Hepatobiliary Surgery
• Oncology

Background:

• Portal vein embolization (PVE) is crucial for inducing liver hypertrophy, thereby minimizing complications after liver resection.
• Pre-operative PVE is essential for patients requiring extensive liver resections, particularly those with colorectal liver metastases.

Purpose of the Study:

• To evaluate the efficacy and safety of PVE using an adapted hysterosalpingography catheter via a transileocolic approach.
• To assess the feasibility of this technique in patients with colorectal liver metastases undergoing hepatectomy.

Main Methods:

• Right portal vein embolization was performed in 19 patients using a hysterosalpingography catheter.
• Gelfoam powder mixed with absolute alcohol was utilized as the embolic agent.
• All patients had indications for hepatectomy due to colorectal liver metastases.

Main Results:

• Successful future remnant liver (FRL) hypertrophy was achieved in 15 patients (78.9%), enabling subsequent hepatectomy in 14 (73.7%).
• One patient experienced tumor progression, precluding surgery.
• One patient developed acute renal failure post-embolization.

Conclusions:

• The hysterosalpingography catheter is user-friendly and can be effectively guided into the portal vein.
• The procedure demonstrated a favorable safety profile with no major post-embolization complications.
• This method is presented as a safe, economical, and effective option for PVE.