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Preliminary experimental evaluation of temporary segmental hepatic venous occlusion: angiographic, pathologic, and
S Kanazawa1, K C Wright, L P Kasi
1Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Purpose:
Pigs were used to evaluate temporary segmental hepatic venous occlusion as a means of improving the selective delivery of therapeutic agents within the liver.
Materials And Methods:
Hepatic angiography and scintigraphy were performed alone and in combination with hepatic venous occlusion.
Results:
Arteriograms obtained during venous obstruction demonstrated a greater number of peripheral arterial branches in the occluded area compared with the nonoccluded areas. A prolonged hepatogram showing hepatofugal opacification of the portal branches was observed in the occluded area. Microscopically, mild congestion of the sinusoids and central veins was seen immediately after 60-minute occlusion, but these changes were not evident 2 hours after balloon deflation. Severe congestion and focal hemorrhage were found in the occluded segment of the liver 2 hours after 90-minute venous occlusion. When the right or left hepatic vein was occluded during hepatic arterial infusion of technetium-99m macroaggregated albumin, there was a significant (P < or = .05) increase in the amount of radioactivity measured in the obstructed segment and a significant (P < or = .05) decrease in that found in the nonoccluded regions.
Conclusion:
These results indicate that temporary segmental hepatic vein occlusion is safe for up to 60 minutes and may be clinically applicable as a means of improving the therapeutic index of agents within the liver when they are administered via concomitant hepatic arterial infusion.