CardioVascular and Interventional Radiology

, Volume 40, Issue 10, pp 1624–1630 | Cite as

Prophylactic Temporary Occlusion of the Cystic Artery Using a Fibered Detachable Coil During 90Y Radioembolization

  • Jin Woo Choi
  • Min Young Yoo
  • Hyo-Cheol Kim
  • Jin Chul Paeng
  • Yoon Jun Kim
  • Jin Wook Chung
Technical Note
First Online:
Received:
Accepted:

Abstract

Purpose

To address the feasibility of prophylactic temporary occlusion of the cystic artery using a detachable coil during 90Y radioembolization.

Materials and Methods

From January 2012 to October 2016, nine patients underwent temporary occlusion of the cystic artery during 90Y radioembolization. Based on the planning hepatic angiography, a detachable coil was deployed into the cystic artery, which arose from a more distal level (e.g., right anterior hepatic artery) than its usual origin, but the proximal 1 cm was left inside the microcatheter. 90Y microspheres were infused proximal to the cystic artery where the 99mTc-MAA had been infused, and then the coil was retrieved. Afterward, the patients underwent PET/CT imaging. Medical records were reviewed, and the differences in the uptake of 99mTc-MAA and 90Y microspheres in the gallbladder were evaluated using Wilcoxon’s signed-rank test.

Results

Temporary placement of a detachable coil was feasible in all cases. On the angiograms obtained after detachable coil placement, the distal cystic artery and gallbladder were partially identifiable in eight of the nine (88.8%) patients, but fully restored after the removal of the coils in all cases. The proportional uptake of 99mTc-MAA (mean, 4.35%) and 90Y (mean, 0.90%) in the gallbladder was significantly different due to the temporary occlusion of the cystic artery (p = 0.004). No clinical complications were identified for three months after the procedure.

Conclusion

Temporary occlusion of the cystic artery using a detachable coil appeared to be feasible and effective in reducing 90Y uptake in the gallbladder.

Keywords

Radioembolization Cystic artery Detachable coil Cholecystitis 
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Notes

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflicts of interest.

References

  1. 1.
    Sangro B, Inarrairaegui M, Bilbao JI. Radioembolization for hepatocellular carcinoma. J Hepatol. 2012;56:464–73.CrossRefPubMedGoogle Scholar
  2. 2.
    Vente MA, Wondergem M, van der Tweel I, et al. Yttrium-90 microsphere radioembolization for the treatment of liver malignancies: a structured meta-analysis. Eur Radiol. 2009;19:951–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Riaz A, Awais R, Salem R. Side effects of yttrium-90 radioembolization. Front Oncol. 2014;4:198.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Prince JF, van den Hoven AF, van den Bosch MA, Elschot M, de Jong HW, Lam MG. Radiation-induced cholecystitis after hepatic radioembolization: do we need to take precautionary measures? J Vasc Interv Radiol. 2014;25:1717–23.CrossRefPubMedGoogle Scholar
  5. 5.
    McWilliams JP, Kee ST, Loh CT, Lee EW, Liu DM. Prophylactic embolization of the cystic artery before radioembolization: feasibility, safety, and outcomes. Cardiovasc Intervent Radiol. 2011;34:786–92.CrossRefPubMedGoogle Scholar
  6. 6.
    Hagspiel KD, Nambiar A, Hagspiel LM, Ahmad EA, Bozlar U. Temporary arterial balloon occlusion as an adjunct to yttrium-90 radioembolization. Cardiovasc Intervent Radiol. 2013;36:809–13.CrossRefPubMedGoogle Scholar
  7. 7.
    Powerski M, Busse A, Seidensticker M, et al. Prophylactic embolization of the cystic artery prior to radioembolization of liver malignancies—an evaluation of necessity. Cardiovasc Intervent Radiol. 2015;38:678–84.CrossRefPubMedGoogle Scholar
  8. 8.
    Paprottka PM, Jakobs TF, Reiser MF, Hoffmann RT. Practical vascular anatomy in the preparation of radioembolization. Cardiovasc Intervent Radiol. 2012;35:454–62.CrossRefPubMedGoogle Scholar
  9. 9.
    Kang B, Kim HC, Chung JW, Hur S, Jae HJ, Park JH. The origin of the cystic artery supplying hepatocellular carcinoma on digital subtraction angiography in 311 patients. Cardiovasc Intervent Radiol. 2014;37:1268–82.CrossRefPubMedGoogle Scholar
  10. 10.
    Theysohn JM, Müller S, Schlaak JF, et al. Selective internal radiotherapy (SIRT) of hepatic tumors: how to deal with the cystic artery. Cardiovasc Intervent Radiol. 2013;36:1015–22.CrossRefPubMedGoogle Scholar

Copyright information

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

Authors and Affiliations

  • Jin Woo Choi
    • 1
  • Min Young Yoo
    • 2
    • 3
  • Hyo-Cheol Kim
    • 1
  • Jin Chul Paeng
    • 3
  • Yoon Jun Kim
    • 4
  • Jin Wook Chung
    • 1
  1. 1.Section of Interventional Radiology, Department of Radiology, Seoul National University HospitalSeoul National University College of MedicineSeoulSouth Korea
  2. 2.Department of Nuclear MedicineChungbuk National University HospitalCheongjuSouth Korea
  3. 3.Department of Nuclear Medicine, Seoul National University HospitalSeoul National University College of MedicineSeoulSouth Korea
  4. 4.Department of Internal Medicine, Seoul National University HospitalSeoul National University College of MedicineSeoulSouth Korea

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