Blood flow diversion using the microvascular plug to avoid non target delivery of radioactive microspheres

Temporary balloon occlusion techniques have been described to redirect blood flow during hepatic chemo- and radioembolization. A 69 years old male with pathologically proven multifocal hepatocellular carcinoma involving all the liver segments except segments 2 and 3. We temporarily occlude segment 2/3 branch with the microvascular plug (MVP) to safely deliver the Y90 glass microspheres through the multiple small segment 4 branches. Distal occlusion using MVP may provide a valuable, cheaper and readily available tool in cases of unfavorable anatomy to divert blood flow and avoid non target delivery of Chemo or Radioembolic agents.