Article Sidebar
Views PDF: 93
The assessement of the safety and efficacy of preoperative portal vein embolization using an Amplatzer vascular plug (AVP)
Main Article Content
Abstract
SUMMARY
Purpose: To determine the safety and efficacy related to the use of Amplatzer Vascular Plugs (AVP) for preoperative portal vein embolization.
Subjects and methods: Between 7/2011-7/2012, a total 16 AVP were embolized into the portal vein of 12 patient (HCC) prior to extended hepatic resection where the residual liver volume (RLV) was deemed sufficient (RLV < 30% in patient with normal liver, RLV
<40% in patient with liver cirrhosis. AVP were used combined with gel foam in 5 patients and histoacryl in 7 patient.
Result: The procedure was technically successful in 100% of cases. The rate of RLV growth was from 30 to 233 cm3 (mean at
133cm3). The rate surgical was 75% (3 patients were excluded: one insufficient growth of RVL, two metastasis). There were no major
complication and minor complication in two patients: abdominal pain.
Conclusion: AVP appear to be safety an effective for the preoperative embolization of portal vein, with low morbidity and sufficient growth of RLV.
Article Details
Keywords
Amplatzer Vascular Plugs, portal vein embolization
References
1. Makuuchi, M., et al., Preoperative portal embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report. Surgery, 1990. 107(5): p. 521-7.
2. Lê Thanh Dũng, Bùi Văn Giang, Ngô Lê Lâm, Lê Tuấn Linh, Trịnh Hồng Sơn, “Nút tĩnh mạch cửa làm phì đại gan trước phẫu thuật nhân 3 trường hợp tiến hành tại bệnh viện Việt Đức”. Y học thực hành 668, 2009. 07/2009.
3. Ribero, D., et al., Portal vein embolization before major hepatectomy and its effects on regeneration, resectability
and outcome. Br J Surg, 2007. 94(11): p. 1386-94.
4. de Baere, T., A. Denys, and V. Paradis, Comparison of four embolic materials for portal vein embolization: experimental study in pigs. Eur Radiol, 2009. 19(6): p. 1435-42.
5. Bent, C.L., et al., Portal vein embolization using a
nitinol plug (Amplatzer vascular plug) in combination with
histoacryl glue and iodinized oil: adequate hypertrophy
with a reduced risk of nontarget embolization. Cardiovasc
Intervent Radiol, 2009. 32(3): p. 471-7.
6. Kalenderian, A.C., et al., [Preoperative portal vein
embolization with Amplatzer((R)) vascular plugs (AVP): a
review of 17 cases]. J Radiol, 2011. 92(10): p. 899-908.
7. Zou, R.H., et al., Liver hypertrophy and accelerated growth of implanted tumors in nonembolized liver of rabbit
after left portal vein embolization. J Surg Res, 2012.
8. Peng, P.D., et al., Sequential intra-arterial therapy and portal vein embolization is feasible and safe in patients with advanced hepatic malignancies. HPB (Oxford), 2012. 14(8): p. 523-31.