Skip to main content
SpringerLink
Log in

Portal vein embolization with N-butyl cyanoacrylate glue is superior to other materials: a systematic review and meta-analysis

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

It remains uncertain which embolization material is best for portal vein embolization (PVE). We investigated the various materials for effectiveness in inducing future liver remnant (FLR) hypertrophy, technical and growth success rates, and complication and resection rates.

Methods

A systematic review from 1998 to 2019 on embolization materials for PVE was performed on Pubmed, Embase, and Cochrane. FLR growth between the two most commonly used materials was compared in a random effects meta-analysis. In a separate analysis using local data (n = 52), n-butyl cyanoacrylate (NBCA) was compared with microparticles regarding costs, radiation dose, and procedure time.

Results

In total, 2896 patients, 61.0 ± 4.0 years of age and 65% male, from 51 papers were included in the analysis. In 61% of the patients, either NBCA or microparticles were used for embolization. The remaining were treated with ethanol, gelfoam, or sclerosing agents. The FLR growth with NBCA was 49.1% ± 29.7 compared to 42.2% ± 40 with microparticles (p = 0.037). The growth success rate with NBCA vs microparticles was 95.3% vs 90.7% respectively (p < 0.001). There were no differences in major complications between NBCA and microparticles. In the local analysis, NBCA (n = 41) entailed shorter procedure time and reduced fluoroscopy time (p < 0.001), lower radiation exposure (p < 0.01), and lower material costs (p < 0.0001) than microparticles (n = 11).

Conclusion

PVE with NBCA seems to be the best choice when combining growth of the FLR, procedure time, radiation exposure, and costs.

Key Points

• The meta-analysis shows that n-butyl cyanoacrylate (NBCA) is superior to microparticles regarding hypertrophy of the future liver remnant, 49.1% ± 29.7 vs 42.2% ± 40.0 (p = 0.037).

• There is no significant difference in major complication rates for portal vein embolization using NBCA, 4% (24/681), compared with microparticles, 5% (25/494) (p > 0.05).

• Local data shows a shorter procedure time, 215 vs 348 mins from arrival to departure at the interventional radiology unit, and fluoroscopy time, 43 vs 96 mins (p < 0.001), lower radiation dosage, 573 vs 1287 Gycm 2 (p < 0.01), and costs, €816 vs €4233 (p < 0.0001) for NBCA compared to microparticles.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

FLR:

Future liver remnant

NBCA:

n-Butyl cyanoacrylate

PVA:

Polyvinyl alcohol

PVE:

Portal vein embolization

TLV:

Total liver volume

References

  1. Farges O, Belghiti J, Kianmanesh R et al (2003) Portal vein embolization before right hepatectomy: prospective clinical trial. Ann Surg 2:208–217

    Article  Google Scholar 

  2. Denys A, Bize P, Demartines N, Deschamps F, De Baere T (2010) Quality improvement for portal vein embolization. Cardiovasc Intervent Radiol 3:452–456

    Article  Google Scholar 

  3. Covey AM, Brown KT, Jarnagin WR et al (2008) Combined portal vein embolization and neoadjuvant chemotherapy as a treatment strategy for resectable hepatic colorectal metastases. Ann Surg 3:451–455

    Article  Google Scholar 

  4. Bae JH, Kim KC, Ryeom HK (2009) Percutaneous preoperative portal vein embolization using a combination of gelatin sponge and histoacryl glue. Acta Radiol 10:1119–1125

    Article  Google Scholar 

  5. Igami T, Ebata T, Yokoyama Y, Sugawara G, Takahashi Y, Nagino M (2014) Portal vein embolization using absolute ethanol: evaluation of its safety and efficacy. J Hepatobiliary Pancreat Sci 9:676–681

    Article  Google Scholar 

  6. Fischman AM, Ward TJ, Horn JC et al (2014) Portal vein embolization before right hepatectomy or extended right hepatectomy using sodium tetradecyl sulfate foam: technique and initial results. J Vasc Interv Radiol 7:1045–1053

    Article  Google Scholar 

  7. van Lienden KP, van den Esschert JW, de Graaf W et al (2013) Portal vein embolization before liver resection: a systematic review. Cardiovasc Intervent Radiol 1:25–34

    Article  Google Scholar 

  8. Wajswol E, Jazmati T, Contractor S, Kumar A (2018) Portal vein embolization utilizing n-butyl cyanoacrylate for contralateral lobe hypertrophy prior to liver resection: a systematic review and meta-analysis. Cardiovasc Intervent Radiol 9:1302–1312

    Article  Google Scholar 

  9. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 7:e1000097

    Article  Google Scholar 

  10. Abdalla EK, Adam R, Bilchik AJ, Jaeck D, Vauthey JN, Mahvi D (2006) Improving resectability of hepatic colorectal metastases: expert consensus statement. Ann Surg Oncol 10:1271–1280

    Article  Google Scholar 

  11. Vauthey JN, Abdalla EK, Doherty DA et al (2002) Body surface area and body weight predict total liver volume in Western adults. Liver Transpl 3:233–240

    Article  Google Scholar 

  12. Johnson TN, Tucker GT, Tanner MS, Rostami-Hodjegan A (2005) Changes in liver volume from birth to adulthood: a meta-analysis. Liver Transpl 12:1481–1493

    Article  Google Scholar 

  13. Urata K, Hashikura Y, Ikegami T, Terada M, Kawasaki S (2000) Standard liver volume in adults. Transplant Proc 7:2093–2094

    Article  Google Scholar 

  14. Angle JF, Siddiqi NH, Wallace MJ et al (2010) Quality improvement guidelines for percutaneous transcatheter embolization: Society of Interventional Radiology Standards of Practice Committee. J Vasc Interv Radiol 10:1479–1486

    Article  Google Scholar 

  15. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2:205–213

    Article  Google Scholar 

  16. Abdalla EK, Barnett CC, Doherty D, Curley SA, Vauthey JN (2002) Extended hepatectomy in patients with hepatobiliary malignancies with and without preoperative portal vein embolization. Arch Surg 6:675–680

    Article  Google Scholar 

  17. Barbaro B, Stasi CD, Nuzzo G, Vellone M, Giuliante F, Marano P (2003) Preoperative right portal vein embolization in patients with metastatic liver disease: metastatic liver volumes after RPVE. Acta Radiol 1:98–102

    Google Scholar 

  18. Cassinotto C, Dohan A, Gallix B et al (2017) Portal vein embolization in the setting of staged hepatectomy with preservation of segment IV ± I only for bilobar colorectal liver metastases: safety, efficacy, and clinical outcomes. J Vasc Interv Radiol 7:963–970

    Article  Google Scholar 

  19. Chijiiwa K, Saiki S, Noshiro H, Kameoka N, Nakano K, Tanaka M (2000) Effect of preoperative portal vein embolization on liver volume and hepatic energy status of the nonembolized liver lobe in humans. Eur Surg Res 2:94–99

    Article  Google Scholar 

  20. Cotroneo AR, Innocenti P, Marano G, Legnini M, Iezzi R (2009) Pre-hepatectomy portal vein embolization: single center experience. Eur J Surg Oncol 1:71–78

    Article  Google Scholar 

  21. Ebata T, Yokoyama Y, Igami T, Sugawara G, Takahashi Y, Nagino M (2012) Portal vein embolization before extended hepatectomy for biliary cancer: current technique and review of 494 consecutive embolizations. Dig Surg 1:23–29

    Article  Google Scholar 

  22. Hemming AW, Reed AI, Howard RJ et al (2003) Preoperative portal vein embolization for extended hepatectomy. Ann Surg 5:686–691

    Article  Google Scholar 

  23. Hocquelet A, Sotiriadis C, Duran R et al (2018) Preoperative portal vein embolization alone with biliary drainage compared to a combination of simultaneous portal vein, right hepatic vein embolization and biliary drainage in Klatskin tumor. Cardiovasc Intervent Radiol 12:1885–1891

    Article  Google Scholar 

  24. Ji W, Li JS, Li LT et al (2003) Role of preoperative selective portal vein embolization in two-step curative hepatectomy for hepatocellular carcinoma. World J Gastroenterol 8:1702–1706

    Article  Google Scholar 

  25. Kalenderian AC, Chabrot P, Buc E et al (2011) Embolisation portale préopératoire par Amplatzer® Vascular Plugs (AVP) : 17 patients. J Radiol 10:899–908

    Article  Google Scholar 

  26. Kishi Y, Abdalla EK, Chun YS et al (2009) Three hundred and one consecutive extended right hepatectomies: evaluation of outcome based on systematic liver volumetry. Ann Surg 4:540–548

    Article  Google Scholar 

  27. Ko HK, Ko G-Y, Sung K-B, Gwon D-I, Yoon H-K (2016) Portal vein embolization via percutaneous transsplenic access prior to major hepatectomy for patients with insufficient future liver remnant. J Vasc Interv Radiol 7:981–986

    Article  Google Scholar 

  28. Leung U, Simpson AL, Araujo RL et al (2014) Remnant growth rate after portal vein embolization is a good early predictor of post-hepatectomy liver failure. J Am Coll Surg 4:620–630

    Article  Google Scholar 

  29. Madoff DC, Abdalla EK, Gupta S et al (2005) Transhepatic ipsilateral right portal vein embolization extended to segment IV: improving hypertrophy and resection outcomes with spherical particles and coils. J Vasc Interv Radiol 2(Pt 1):215–225

    Article  Google Scholar 

  30. Nagino M, Kamiya J, Nishio H, Ebata T, Arai T, Nimura Y (2006) Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: surgical outcome and long-term follow-up. Ann Surg 3:364–372

    Article  Google Scholar 

  31. Nanashima A, Sumida Y, Abo T et al (2009) Clinical significance of portal vein embolization before right hepatectomy. Hepatogastroenterology 91-92:773–777

    Google Scholar 

  32. Peynircioglu B, Cil B, Ozkan F et al (2012) Portal vein embolization with different embolic agents for right hepatectomy. Turk J Gastroenterol 2:148–155

    Article  Google Scholar 

  33. Ratti F, Soldati C, Catena M, Paganelli M, Ferla G, Aldrighetti L (2010) Role of portal vein embolization in liver surgery: single centre experience in sixty-two patients. Updates Surg 3-4:153–159

    Article  Google Scholar 

  34. Ribero D, Abdalla EK, Madoff DC, Donadon M, Loyer EM, Vauthey JN (2007) Portal vein embolization before major hepatectomy and its effects on regeneration, resectability and outcome. Br J Surg 11:1386–1394

    Article  Google Scholar 

  35. Tanaka K, Shimada H, Matsuo K, Ueda M, Endo I, Togo S (2007) Remnant liver regeneration after two-stage hepatectomy for multiple bilobar colorectal metastases. Eur J Surg Oncol 3:329–335

    Article  Google Scholar 

  36. van den Esschert JW, de Graaf W, van Lienden KP et al (2009) Volumetric and functional recovery of the remnant liver after major liver resection with prior portal vein embolization : recovery after PVE and liver resection. J Gastrointest Surg 8:1464–1469

    Article  Google Scholar 

  37. Yamashita S, Sakamoto Y, Yamamoto S et al (2017) Efficacy of preoperative portal vein embolization among patients with hepatocellular carcinoma, biliary tract cancer, and colorectal liver metastases: a comparative study based on single-center experience of 319 cases. Ann Surg Oncol 6:1557–1568

    Article  Google Scholar 

  38. Imamura H, Shimada R, Kubota M et al (1999) Preoperative portal vein embolization: an audit of 84 patients. Hepatology 4:1099–1105

    Article  Google Scholar 

  39. Sugawara Y, Yamamoto J, Higashi H et al (2002) Preoperative portal embolization in patients with hepatocellular carcinoma. World J Surg 1:105–110

    Article  Google Scholar 

  40. Broering DC, Hillert C, Krupski G et al (2002) Portal vein embolization vs. portal vein ligation for induction of hypertrophy of the future liver remnant. J Gastrointest Surg 6:905–913

    Article  PubMed  Google Scholar 

  41. Geisel D, Malinowski M, Powerski MJ et al (2014) Improved hypertrophy of future remnant liver after portal vein embolization with plugs, coils and particles. Cardiovasc Intervent Radiol 5:1251–1258

    Article  Google Scholar 

  42. Alvarez FA, Castaing D, Figueroa R et al (2018) Natural history of portal vein embolization before liver resection: a 23-year analysis of intention-to-treat results. Surgery 6:1257–1263

    Article  Google Scholar 

  43. Shindoh J, Tzeng CW, Aloia TA et al (2013) Portal vein embolization improves rate of resection of extensive colorectal liver metastases without worsening survival. Br J Surg 13:1777–1783

    Article  Google Scholar 

  44. Tranchart H, Catherine L, Maitre S, Lainas P, De Laveaucoupet J, Dagher I (2015) Efficient liver regeneration following temporary portal vein embolization with absorbable gelatin sponge powder in humans. J Vasc Interv Radiol 4:507–515

    Article  Google Scholar 

  45. Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 1:13

    Article  Google Scholar 

  46. Borenstein M, Hedges LV, Higgins JP, Rothstein HR (2010) A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods 2:97–111

    Article  Google Scholar 

  47. Sirichindakul B, Nonthasoot B, Taesombat W et al (2007) Role of portal vein embolization in hepatobiliary malignancy. Hepatogastroenterology 80:2297–2300

    Google Scholar 

  48. Ogata S, Belghiti J, Farges O, Varma D, Sibert A, Vilgrain V (2006) Sequential arterial and portal vein embolizations before right hepatectomy in patients with cirrhosis and hepatocellular carcinoma. Br J Surg 9:1091–1098

    Article  Google Scholar 

  49. Nafidi O, Désy D, Létourneau R et al (2009) Hypertrophy of the non-embolized liver after chemotherapy. HPB (Oxford) 2:103–107

    Article  Google Scholar 

  50. Mukund A, Mondal A, Patidar Y, Kumar S (2019) Safety and outcomes of pre-operative portal vein embolization using N-butyl cyanoacrylate (Glue) in hepatobiliary malignancies: a single center retrospective analysis. Indian J Radiol Imaging 1:40–46

    Google Scholar 

  51. Luz JHM, Luz PM, Bilhim T et al (2017) Portal vein embolization with n-butyl-cyanoacrylate through an ipsilateral approach before major hepatectomy: single center analysis of 50 consecutive patients. Cancer Imaging 1:25

    Article  Google Scholar 

  52. Jaeck D, Bachellier P, Nakano H et al (2003) One or two-stage hepatectomy combined with portal vein embolization for initially nonresectable colorectal liver metastases. Am J Surg 3:221–229

    Article  Google Scholar 

  53. Giraudo G, Greget M, Oussoultzoglou E, Rosso E, Bachellier P, Jaeck D (2008) Preoperative contralateral portal vein embolization before major hepatic resection is a safe and efficient procedure: a large single institution experience. Surgery 4:476–482

    Article  Google Scholar 

  54. Elias D, Ouellet J-F, de Baère T, Lasser P, Roche A (2002) Preoperative selective portal vein embolization before hepatectomy for liver metastases: long-term results and impact on survival. Surgery 3:294–299

    Article  Google Scholar 

  55. Denys A, Lacombe C, Schneider F et al (2005) Portal vein embolization with n-butyl cyanoacrylate before partial hepatectomy in patients with hepatocellular carcinoma and underlying cirrhosis or advanced fibrosis. J Vasc Interv Radiol 12:1667–1674

    Article  Google Scholar 

  56. de Baere T, Teriitehau C, Deschamps F et al (2010) Predictive factors for hypertrophy of the future remnant liver after selective portal vein embolization. Ann Surg Oncol 8:2081–2089

    Article  Google Scholar 

  57. Collin Y, Pare A, Belblidia A et al (2019) Portal vein embolization does not affect the long-term survival and risk of cancer recurrence among colorectal liver metastases patients: a prospective cohort study. Int J Surg 1:42–47

    Article  Google Scholar 

  58. Capussotti L, Muratore A, Baracchi F et al (2008) Portal vein ligation as an efficient method of increasing the future liver remnant volume in the surgical treatment of colorectal metastases. Arch Surg 10:978–982

    Article  Google Scholar 

  59. Breguet R, Boudabbous S, Pupulim LF et al (2018) Ethylene vinyl alcohol copolymer for occlusion of specific portal branches during preoperative portal vein embolisation with n-butyl-cyanoacrylate. Eur Radiol 11:4810–4817

    Article  Google Scholar 

  60. Bent CL, Low D, Matson MB, Renfrew I, Fotheringham T (2009) 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 3:471–477

    Article  Google Scholar 

  61. Bellemann N, Stampfl U, Sommer CM, Kauczor HU, Schemmer P, Radeleff BA (2012) Portal vein embolization using a Histoacryl/Lipiodol mixture before right liver resection. Dig Surg 3:236–242

    Article  Google Scholar 

  62. Barbaro B, Caputo F, Tebala C et al (2009) Preoperative right portal vein embolisation: indications and results. Radiol Med 4:553–570

    Article  Google Scholar 

  63. Azoulay D, Castaing D, Krissat J et al (2000) Percutaneous portal vein embolization increases the feasibility and safety of major liver resection for hepatocellular carcinoma in injured liver. Ann Surg 5:665–672

    Article  Google Scholar 

  64. Zeile M, Bakal A, Volkmer JE et al (2016) Identification of cofactors influencing hypertrophy of the future liver remnant after portal vein embolization—the effect of collaterals on embolized liver volume. Br J Radiol 1068:20160306

    Article  Google Scholar 

  65. Massimino KP, Kolbeck KJ, Enestvedt CK, Orloff S, Billingsley KG (2012) Safety and efficacy of preoperative right portal vein embolization in patients at risk for postoperative liver failure following major right hepatectomy. HPB (Oxford) 1:14–19

    Article  Google Scholar 

  66. Libicher M, Herbrik M, Stippel D, Poggenborg J, Bovenschulte H, Schwabe H (2010) Portal vein embolization using the amplatzer vascular plug II: preliminary results. Rofo 6:501–506

    Article  Google Scholar 

  67. de Graaf W, Van Lienden K, Van Den Esschert J, Bennink R, Van Gulik T (2011) Increase in future remnant liver function after preoperative portal vein embolization. Br J Surg 6:825–834

    Article  Google Scholar 

  68. Cazejust J, Bessoud B, Le Bail M, Menu Y (2015) Preoperative portal vein embolization with a combination of trisacryl microspheres, gelfoam and coils. Diagn Interv Imaging 1:57–64

    Article  Google Scholar 

  69. Sofue K, Arai Y, Shimada K et al (2014) Right portal vein embolization with absolute ethanol in major hepatic resection for hepatobiliary malignancy. Br J Surg 9:1122–1128

    Article  Google Scholar 

  70. Sakuhara Y, Abo D, Hasegawa Y et al (2012) Preoperative percutaneous transhepatic portal vein embolization with ethanol injection. AJR Am J Roentgenol 4:914–922

    Article  Google Scholar 

  71. Ryota H, Kojiro S, Tomoki E et al (2015) Assessment of percutaneous transhepatic portal vein embolization with portal vein stenting for perihilar cholangiocarcinoma with severe portal vein stenosis. J Hepatobiliary Pancreat Sci 4:310–315

    Google Scholar 

  72. Yoo H, Ko GY, Gwon DI et al (2009) Preoperative portal vein embolization using an amplatzer vascular plug. Eur Radiol 5:1054–1061

    Article  Google Scholar 

  73. Wakabayashi H, Ishimura K, Okano K et al (2002) Application of preoperative portal vein embolization before major hepatic resection in patients with normal or abnormal liver parenchyma. Surgery 1:26–33

    Article  Google Scholar 

  74. Shin SW, Chang IS, Choo SW et al (2015) Comparison of the effectiveness of preoperative portal vein embolization in patients with chronic liver disease: gelfoam versus gelfoam-coil combination. J Korean Soc Radiol 5:335–343

    Article  Google Scholar 

  75. Komada T, Suzuki K, Mizuno T et al (2018) Efficacy of percutaneous transhepatic portal vein embolization using gelatin sponge particles and metal coils. Acta Radiol Open 4:2058460118769687

    Google Scholar 

  76. Kim MJ, Choo SW, Do YS et al (2004) Use of double-occlusion balloon catheter: preoperative portal vein embolization for induction of future remnant liver hypertrophy. Cardiovasc Intervent Radiol 1:16–20

    Google Scholar 

  77. Kakizawa H, Toyota N, Arihiro K et al (2006) Preoperative portal vein embolization with a mixture of gelatin sponge and iodized oil: efficacy and safety. Acta Radiol 10:1022–1028

    Article  Google Scholar 

  78. Okabe H, Beppu T, Ishiko T et al (2011) Preoperative portal vein embolization (PVE) for patients with hepatocellular carcinoma can improve resectability and may improve disease-free survival. J Surg Oncol 6:641–646

    Article  Google Scholar 

  79. Inoue S, Ikeda O, Nakasone Y et al (2015) Percutaneous transhepatic portal embolization using foam ethanolamine oleate and carbon dioxide (CO(2)): a pilot study. Acta Radiol 11:1361–1367

    Article  Google Scholar 

  80. Chung SH, Lee MS, Kim KS et al (2011) Foam sclerotherapy using polidocanol (aethoxysklerol) for preoperative portal vein embolization in 16 patients. Cardiovasc Intervent Radiol 6:1236–1243

    Article  Google Scholar 

  81. Jaberi A, Toor SS, Rajan DK et al (2016) Comparison of clinical outcomes following glue versus polyvinyl alcohol portal vein embolization for hypertrophy of the future liver remnant prior to right hepatectomy. J Vasc Interv Radiol 12:1897–1905.e1891

    Article  Google Scholar 

  82. Guiu B, Bize P, Gunthern D, Demartines N, Halkic N, Denys A (2013) Portal vein embolization before right hepatectomy: improved results using n-butyl-cyanoacrylate compared to microparticles plus coils. Cardiovasc Intervent Radiol 5:1306–1312

    Article  Google Scholar 

  83. Malinowski M, Geisel D, Stary V et al (2015) Portal vein embolization with plug/coils improves hepatectomy outcome. J Surg Res 1:202–211

    Article  Google Scholar 

  84. Peregrin JH, Janousek R, Kautznerova D et al (2015) A comparison of portal vein embolization with poly(2-hydroxyethylmethacrylate) and a histoacryl/lipiodol mixture in patients scheduled for extended right hepatectomy. Physiol Res 6:841–848

    Article  Google Scholar 

  85. Loffroy R, Favelier S, Chevallier O et al (2015) Preoperative portal vein embolization in liver cancer: indications, techniques and outcomes. Quant Imaging Med Surg 5:730–739

    PubMed  PubMed Central  Google Scholar 

  86. Rassam F, Olthof PB, van Lienden KP et al (2019) Functional and volumetric assessment of liver segments after portal vein embolization: differences in hypertrophy response. Surgery 4:686–695

    Article  Google Scholar 

  87. Hasselgren K, Sandstrom P, Rosok BI et al (2019) Future liver remnant (FLR) increase in patients with colorectal liver metastases is highest the first week after portal vein occlusion : FLR increase in patients with CRLM is highest the first week after PVO. J Gastrointest Surg 3:556–562

    Article  Google Scholar 

  88. Sandstrom P, Rosok BI, Sparrelid E et al (2018) ALPPS improves resectability compared with conventional two-stage hepatectomy in patients with advanced colorectal liver metastasis: results from a scandinavian multicenter randomized controlled trial (LIGRO trial). Ann Surg 5:833–840

    Article  Google Scholar 

  89. Guiu B, Chevallier P, Denys A et al (2016) Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique. Eur Radiol 12:4259–4267

    Article  Google Scholar 

Download references

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK

    Adnan Ali

  2. Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden

    Margareta Ahle

  3. Department of Surgery and Clinical and Experimental Medicine, University Hospital of Linköping, Linköping, Sweden

    Bergthor Björnsson & Per Sandström

Authors
  1. Adnan Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Margareta Ahle
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bergthor Björnsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Per Sandström
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Adnan Ali.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Per Sandström, Department of Surgery and Clinical and Experimental Medicine, University Hospital of Linköping, Sweden.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was not required for this study because this is a systematic review and meta-analysis of publicly available published data. Also included is a retrospective analysis of our center data which is collected routinely at our institution in an encrypted format with patients giving consent at the time for it to be used for education and research in an anonymized fashion.

Ethical approval

Institutional Review Board approval was not required because this is a systematic review and meta-analysis of already published publicly available data. Also included is a retrospective analysis of our center data which is collected routinely at our institution in an encrypted format with patients giving consent at the time for it to be used for education and research in an anonymized fashion. Review board approval is not required at your center for such studies.

Methodology

• Retrospective

• Observational

• Performed at one institution

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

ESM 1

(DOCX 65.9 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ali, A., Ahle, M., Björnsson, B. et al. Portal vein embolization with N-butyl cyanoacrylate glue is superior to other materials: a systematic review and meta-analysis. Eur Radiol 31, 5464–5478 (2021). https://doi.org/10.1007/s00330-020-07685-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-020-07685-w

Keywords

Search

Navigation