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The technical aspects of a feasible new technique for ipsilateral percutaneous transhepatic portal vein embolization
Masakatsu Tsurusaki1, Teruyoshi Oda1, Keitaro Sofue2
11 Department of Radiology, Kindai University, Faculty of Medicine , Osakasayama , Japan.
Objective::
To devise a simple new technique wherein absolute ethanol is injected via a sheath under proximal balloon occlusion of the right portal vein using a single-balloon catheter and to examine its feasibility and safety for ipsilateral portal vein embolization (PVE).
Methods::
Between 2010 and 2016, PVE was performed in 19 patients prior to undergoing extended right hepatectomy. PVE was performed via a percutaneous transhepatic ipsilateral approach, the right portal branch was embolized under ultrasound guidance, and a balloon catheter was placed in the proximal site of the main right portal branch. Absolute ethanol was injected through a sheath under proximal balloon occlusion of the right portal vein using a double-lumen catheter. We evaluated its technical success and complications following PVE and changes in liver enzyme levels. Furthermore, we calculated changes in future liver remnant (FLR) and FLR/total functional liver volume (TFLV) ratio and assessed complications following hepatic resection.
Results::
PVE was successfully performed in all patients. Mean FLR and FLR/TFLV significantly increased following PVE (p < 0.01). The change in the FLR and FLR/TFLV ratio was 39.6 ± 16.2%. One patient (6.5%) developed procedure-related complications following PVE (perihepatic hematoma).
Conclusion::
The new technique for ipsilateral right PVE is safe, effective, and convenient.
Advances In Knowledge::
This is the first study to investigate the efficacy of injecting ethanol via a sheath under proximal balloon occlusion of the right portal vein using a single-balloon catheter.
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