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Preoperative portal vein embolization using an amplatzer vascular plug

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Abstract

The purpose was to evaluate the safety and efficacy of preoperative portal vein embolization (PVE) using an Amplatzer vascular plug (AVP). Forty-one patients who underwent PVE using gelatin sponge particles and the AVP were enrolled. The right portal branches were embolized using gelatin sponges (1–8 mm3) through a 5-F catheter, and the AVP was deployed at the first- or second-order right portal vein. Technical success and complications, recanalization, and changes of total estimated liver volumes (TELV), future liver remnant (FLR), and FLR/TELV were evaluated. Follow-up CT performed 6–43 days (median, 16 days) after PVE was used to evaluate volume parameters. PVE was technically successful in 40 of 41 patients. Major complications occurred in two patients, with one each having extensive portal vein thrombosis and liver abscess. Partial recanalization of the occluded portal vein was seen in one patient. The mean FLR volume (653 ± 174 ml vs. 532 ± 154 ml, p < 0.001) and mean FLR/TELV ratio (43 ± 8% vs 36 ± 7%, p < 0.001) were significantly higher after than before PVE. PVE using the AVP seems to be a relatively safe and effective technique for inducing hypertrophy of the FLR with minimal risk of recanalization.

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Abbreviations

AVP:

Amplatzer vascular plug

PV:

Portal vein

PVE:

Portal vein embolization

TELV:

Total estimated liver volumes

FLR:

Future liver remnant

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Hyunkyung Yoo, Gi-Young Ko, Dong Il Gwon, Jin-Hyoung Kim, Hyun-Ki Yoon & Kyu-Bo Sung

  2. School of Electrical Engineering and Computer Science, Seoul National University, Shinlim 9-dong, Kwanak-gu, Seoul, Republic of Korea

    Namguk Kim & Jeongjin Lee

  3. Department of Radiology, Asan Medical Center, 388-1 Poongnap-2-dong Songpa-ku, Seoul, 138-040, Korea

    Gi-Young Ko

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  1. Hyunkyung Yoo
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  2. Gi-Young Ko
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  3. Dong Il Gwon
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  4. Jin-Hyoung Kim
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  5. Hyun-Ki Yoon
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  6. Kyu-Bo Sung
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  7. Namguk Kim
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  8. Jeongjin Lee
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Correspondence to Gi-Young Ko.

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Yoo, H., Ko, GY., Gwon, D.I. et al. Preoperative portal vein embolization using an amplatzer vascular plug. Eur Radiol 19, 1054–1061 (2009). https://doi.org/10.1007/s00330-008-1240-2

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  • DOI: https://doi.org/10.1007/s00330-008-1240-2

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