Document Detail


Transarterial versus transhepatic portal vein embolization to induce selective hepatic hypertrophy: a comparative study in swine.
MedLine Citation:
PMID:  17296708     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Portal vein embolization (PVE) is used to induce liver hypertrophy for surgical candidates with marginal future liver remnant (FLR) volumes. We compared the feasibility, safety, and effectiveness of a transarterial approach for PVE (TA-PVE) with those of a transhepatic approach for PVE (TH-PVE) in a swine model. MATERIALS AND METHODS: Ten experimental pigs (TA-PVE, n = 5; TH-PVE, n = 5) and six controls (TA, n = 3; TH, n = 3) were studied. For TA-PVE, a microcatheter was advanced into arteries supplying the left and left middle hepatic lobes. A 3 to 1 Ethiodol-ethanol mixture was infused into selected arteries to cross the arterioportal peribiliary plexus and remain within the portal veins (PVs). For TH-PVE, PVs in the same lobar distribution were embolized with 355- to 500-micro m polyvinyl alcohol particles and coils. Controls were similarly catheterized for saline infusion. Computed tomography with volumetry was performed before and 7, 14, 21, and 28 days after PVE to assess FLR hypertrophy (absolute FLR volume change and FLR/total liver volume [TLV]). Computed tomographic volumetry, laboratory data, and histopathology were compared between groups. RESULTS: All procedures were technically successful. The increases in mean absolute FLR volume (TA-PVE, 148 +/- 84 cm(3); TH-PVE, 62 +/- 19 cm(3); P = .082), mean FLR hypertrophy (TA-PVE, 93.2%; TH-PVE, 48.4%; P = .178), and mean FLR/TLV (TA-PVE, 31.0%; TH-PVE, 16.2%; P = .130) from day 0 to day 28 between experimental groups were better for TA-PVE. Changes in laboratory data among all groups were minimal. Two complications occurred from TA-PVE (right gastric artery embolization [n = 2] without sequela) and two from TH-PVE (acute segmental right PV thrombosis [n = 1]; death 3 weeks after PVE of unknown cause [n = 1]). CONCLUSIONS: Transarterial portal vein embolization is feasible, safe, and effective for inducing future liver remnant hypertrophy in swine and may represent an improvement over previously reported transhepatic portal vein embolization methods.
Authors:
David C Madoff; Sanjay Gupta; Edmund P Pillsbury; Zuxing Kan; Peggy T Tinkey; L Clifton Stephens; Joe E Ensor; Marshall E Hicks; Kenneth C Wright
Related Documents :
16465568 - Hepatic portal venous gas in a patient with enterovascular fistula.
14501488 - In vivo efficiency of four commercial monopolar radiofrequency ablation systems: a comp...
17503028 - Bowel venous malformation associated with an aneurysm of the portal vein.
3047218 - Sonographic demonstration of hepatic venous gas in mesenteric arterial thrombosis.
9540428 - Recanalization of chronic peripheral arterial occlusions by alternating intra-arterial ...
15548188 - A technique for infusion of cardioplegic solution in coronary artery bypass with aortic...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  18     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-02-13     Completed Date:  2007-03-29     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-93     Citation Subset:  IM    
Affiliation:
John S Dunn Center for Radiological Sciences, Division of Diagnostic Imaging, Interventional Radiology Section, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009, USA. dmadoff@di.mdacc.tmc.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Catheterization / methods*
Embolization, Therapeutic / adverse effects,  methods*
Feasibility Studies
Hepatic Artery
Hepatomegaly / chemically induced*
Liver / pathology*
Portal Vein*
Portography
Regression Analysis
Swine
Tomography, X-Ray Computed
Grant Support
ID/Acronym/Agency:
CA-16672/CA/NCI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Iododeoxyuridine uptake in proliferating smooth muscle cells in vitro.
Next Document:  Intraarterial therapy with a new potent inhibitor of tumor metabolism (3-bromopyruvate): identificat...