Assessing Intra-arterial Complications of Planning and Treatment Angiograms for Y-90 Radioembolization

  • Osman Ahmed
  • Mikin V. Patel
  • Abdulrahman Masrani
  • Bradford Chong
  • Mohammed Osman
  • Jordan Tasse
  • Jayesh Soni
  • Ulku Cenk Turba
  • Bulent Arslan
Clinical Investigation
First Online:
Received:
Accepted:

Abstract

Purpose

To report hepatic arterial-related complications encountered during planning and treatment angiograms for radioembolization and understand any potential-associated risk factors.

Materials and Methods

518 mapping or treatment angiograms for 180 patients with primary or metastatic disease to the liver treated by Yttrium-90 radioembolization between 2/2010 and 12/2015 were retrospectively reviewed. Intra-procedural complications were recorded per SIR guidelines. Patient demographics, indication for treatment, prior exposure to chemotherapeutic agents, operator experience, and disease burden were reviewed. Technical variables including type of radioembolic (glass vs. resin microspheres), indication for angiography (mapping vs. treatment), variant anatomy, and attempts at coil embolization were also assessed.

Results

Thirteen (13/518, 2.5%) arterial-related complications occurred in 13 patients. All but two complications resulted during transcatheter coil embolization to prevent non-target embolization. Complications included coil migration (n = 6), arterial dissection (n = 2), focal vessel perforation (n = 2), arterial thrombus (n = 2), and vasospasm prohibiting further arterial sub-selection (n = 1). Transarterial coiling was identified as a significant risk factor of complications on both univariate and multivariate regression analysis (odds ratio 7.8, P = 0.004). Usage of resin microspheres was also a significant risk factor (odds ratio 9.5, P = 0.042). No other technical parameters or pre-procedural variables were significant after adjusting for confounding on multivariate analysis (P > 0.05).

Conclusion

Intra-procedural hepatic arterial complications encountered during radioembolization were infrequent but occurred mainly during coil embolization to prevent non-target delivery to extra-hepatic arteries.

Keywords

Radioembolization Complication Selective internal radiation therapy Arterial complication 
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Notes

Compliance with Ethical Standards

Conflict of interest

Bulent Arslan is a speaker and advisory board member for Penumbra®, Medtronic/Covidien®, and speaker for Cook®, W.L. Gore®, Guerbet®, and CR Bard®.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  1. 1.Section of Interventional Radiology, Department of RadiologyRush University Medical CenterChicagoUSA
  2. 2.Department of RadiologyUniversity of ChicagoChicagoUSA

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