Comparison of Clinical Outcomes following Glue versus Polyvinyl Alcohol Portal Vein Embolization for Hypertrophy of the Future Liver Remnant prior to Right Hepatectomy

作者：Jaberi Arash^*; Toor Sundeep S; Rajan Dheeraj K; Mironov Oleg; Kachura John R; Cleary Sean P; Smoot Rory; St Germain Amelie Tremblay; Tan Kongteng

来源：Journal of Vascular and Interventional Radiology, 2016, 27(12): 1897-1905.

DOI：10.1016/j.jvir.2016.05.023

Purpose: To report outcomes after portal vein embolization (PVE) and right hepatectomy in patients receiving embolization with N-butyl cyanoacrylate (NBCA) glue + central AMPLATZER Vascular Plug (AVP; glue group) or polyvinyl alcohol (PVA) particles +/- coils (PVA group).
Materials and Methods: Between March 2008 and August 2013, all patients having PVE with NBCA + AVP or PVA +/- coils before right hepatectomy were retrospectively reviewed; 85 patients underwent PVE with NBCA + AVP (n = 45) or PVA +/- coils (n = 40). The groups were compared using Mann-Whitney U and chi(2) tests.
Results: Technical success of embolization was 100%. Degree of hypertrophy (16.2% +/- 7.8 vs 12.3% +/- 7.62, P = .009) and kinetic growth rate (3.5%/wk +/- 2.0 vs 2.6%/wk +/- 1.9, P = .016) were greater in the glue group versus the PVA group. Contrast volume (66.1 mL +/- 44.8 vs 189.87 mL +/- 62.6, P < .001) and fluoroscopy time (11.2 min +/- 7.8 vs 23.49 min +/- 11.7, P < .001) were significantly less during the PVE procedure in the glue group. Surgical outcomes were comparable between groups, including the number of patients unable to go onto surgery (P = 1.0), surgical complications (P = .30), length of hospital stay (P = .68), and intensive care unit admissions (P = .71). There was 1 major complication (hepatic abscess) in each group after PVE.
Conclusions: PVE performed with NBCA + AVP compared with PVA coils resulted in greater degree of hypertrophy of the future liver remnant, less fluoroscopic time and contrast volume, and similar complication rates.

• 出版日期2016-12