REGULAR CONTENT
Final ID
560
Type
Original Scientific Research-Poster Only
Authors
M Ranade1, A Zybulewski2, N Tabori3, F Nowakowski3, R Lookstein1, E Kim4, R Patel4, A Fischman5
Institutions
1Mount Sinai Hospital, New York, NY, 2Mount Sinai Beth Israel, New York, NY, 3N/A, New York, NY, 4Mount Sinai Medical Center, New York, NY, 5Icahn School of Medicine at Mount Sinai, New York, NY
Purpose
Portal vein embolization (PVE) can be used to redistribute portal blood flow and induce hypertrophy of future remnant liver (FRL) in patients with initially insufficient remnant liver volumes. (1) Several embolic materials are utilized for PVE including gelfoam, coils, fibrin glue, alcohol, n-butyl cyanoacrylate and particles without consensus for which embolic material induces the greatest degree of hypertrophy. This study compares the efficacy of N-butyl cyanoacrylate or Histoacryl glue to sodium tetradecyl sulfate (STS) foam.
Materials & Methods
A single center retrospective review of PVE procedures performed between 1/1/2014 to 8/30/2016 revealed 33 patients who underwent PVE with STS foam or n-BCA/Histoacryl glue. Exclusion criteria involved lack of pre- or post-procedure imaging or usage of other embolization material. The technical success rate, rate of PVE at producing adequate FRL hypertrophy and rate of disease progression precluding resection after PVE were analyzed. Complications of PVE were recorded. Liver volumes were calculated on 4 - 6 week post-procedural follow up scans.
Results
PVE was performed on 19 patients using either STS foam (n=10) or n-BCA glue (n=9) prior to planned right hepatic resection for hepatic malignancy (7 HCC, 7 cholangiocarcinoma, 3 gallbladder carcinoma and 2 colorectal metastases). TS was achieved in 100%. Mean FLR of the total estimated liver volume increased from 19.5% (SD, 6.3) to 27.4% (SD, 8.2) in the STS group and 21.2% (SD, 10) to 31.3% (SD, 13.6) in the glue group, corresponding to a percentage increase of 42.9% (SD, 25.7) and 51.5% (SD, 13.9) for the two groups, respectively (p=0.39). PVE produced adequate FLR in 80% of STS patients and 100% of glue patients. No adverse events occurred up to 30 days.
Conclusions
Pre-operative PVE with STS foam and glue are comparable to induce hypertrophy of the FRL.
Final ID
560
Type
Original Scientific Research-Poster Only
Authors
M Ranade1, A Zybulewski2, N Tabori3, F Nowakowski3, R Lookstein1, E Kim4, R Patel4, A Fischman5
Institutions
1Mount Sinai Hospital, New York, NY, 2Mount Sinai Beth Israel, New York, NY, 3N/A, New York, NY, 4Mount Sinai Medical Center, New York, NY, 5Icahn School of Medicine at Mount Sinai, New York, NY
Purpose
Portal vein embolization (PVE) can be used to redistribute portal blood flow and induce hypertrophy of future remnant liver (FRL) in patients with initially insufficient remnant liver volumes. (1) Several embolic materials are utilized for PVE including gelfoam, coils, fibrin glue, alcohol, n-butyl cyanoacrylate and particles without consensus for which embolic material induces the greatest degree of hypertrophy. This study compares the efficacy of N-butyl cyanoacrylate or Histoacryl glue to sodium tetradecyl sulfate (STS) foam.
Materials & Methods
A single center retrospective review of PVE procedures performed between 1/1/2014 to 8/30/2016 revealed 33 patients who underwent PVE with STS foam or n-BCA/Histoacryl glue. Exclusion criteria involved lack of pre- or post-procedure imaging or usage of other embolization material. The technical success rate, rate of PVE at producing adequate FRL hypertrophy and rate of disease progression precluding resection after PVE were analyzed. Complications of PVE were recorded. Liver volumes were calculated on 4 - 6 week post-procedural follow up scans.
Results
PVE was performed on 19 patients using either STS foam (n=10) or n-BCA glue (n=9) prior to planned right hepatic resection for hepatic malignancy (7 HCC, 7 cholangiocarcinoma, 3 gallbladder carcinoma and 2 colorectal metastases). TS was achieved in 100%. Mean FLR of the total estimated liver volume increased from 19.5% (SD, 6.3) to 27.4% (SD, 8.2) in the STS group and 21.2% (SD, 10) to 31.3% (SD, 13.6) in the glue group, corresponding to a percentage increase of 42.9% (SD, 25.7) and 51.5% (SD, 13.9) for the two groups, respectively (p=0.39). PVE produced adequate FLR in 80% of STS patients and 100% of glue patients. No adverse events occurred up to 30 days.
Conclusions
Pre-operative PVE with STS foam and glue are comparable to induce hypertrophy of the FRL.