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Foam Sclerotherapy Using Polidocanol (Aethoxysklerol) for Preoperative Portal Vein Embolization in 16 Patients

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Abstract

Purpose

To evaluate the clinical safety and effectiveness of foam sclerotherapy using polidocanol for preoperative portal vein embolization (PVE) before hemihepatectomy of the liver.

Materials and Methods

From March 2006 to October 2008, foam sclerotherapy using polidocanol was performed in 16 patients (male-to-female ratio of 12:4, age range 48–75 years [mean 62]) for PVE. Patients were diagnosed with Klatskin tumor (n = 13), gallbladder (GB) cancer (n = 2), or hepatocellular carcinoma (HCC) (n = 1). The foam was composed of a 1:2:1 ratio of 3% polidocanol (Aethoxysklerol; Kreussler Pharma, Wiesbaden, Germany), room air, and contrast media (Xenetix 350; Guerbet, Aulnay-Sous-Bois, France). The total amount of polidocanol used (2 to 8 mL [mean 4.6]) varied according to the volume of the target portal vein. We calculated the volume of future liver remnant (FLR) before and after PVE and evaluated complications associated with the use of polidocanol foam sclerotherapy for PVE.

Results

Technical success was achieved in all patients. All patients were comfortable throughout the procedure and did not experience pain during sclerotherapy. No periprocedural morbidity or mortality occurred. Patients underwent a liver dynamic computed tomography (CT) scan 2–4 weeks after PVE. FLR increased significantly after PVE using polidocanol foam from 19.3% (range 16–35%) before PVE to 27.8% (range 23–42%) after PVE (p = 0.001). All patients were operable for hemihepatectomy of the liver and achieved effective resection.

Conclusion

Foam sclerotherapy using polidocanol is clinically safe and effective for preoperative PVE.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiologic Science, Severance Hospital, College of Medicine, University of Yonsei, 143, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea

    Sang-Hoon Chung, Myung-su Lee, Do Yun Lee & Kwang-Hun Lee

  2. Department of Surgery, Severance Hospital, College of Medicine, University of Yonsei, 143, Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea

    Kyung Sik Kim & Soon II Kim

  3. Department of Radiology, Gangnam Severance Hospital, College of Medicine, University of Yonsei, 612 Eonjuro, Gangnam-gu, Seoul, Republic of Korea

    Jong Youn Won

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  1. Sang-Hoon Chung
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Correspondence to Kwang-Hun Lee.

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Chung, SH., Lee, Ms., Kim, K.S. et al. Foam Sclerotherapy Using Polidocanol (Aethoxysklerol) for Preoperative Portal Vein Embolization in 16 Patients. Cardiovasc Intervent Radiol 34, 1236–1243 (2011). https://doi.org/10.1007/s00270-010-0079-5

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