Hepatic vein embolization after portal vein embolization to induce additional liver hypertrophy in patients with metastatic colorectal carcinoma

European Radiology
Andrew S NiekampJean-Nicolas Vauthey

Abstract

To assess the effect of salvage hepatic vein embolization (HVE) on the volume of the future liver remnant (FLR) for patients with metastatic colorectal cancer (mCRC) and inadequate hypertrophy following initial portal vein embolization (PVE). From April 2011 to October 2018, 9 patients with mCRC underwent HVE following PVE. The right or middle hepatic vein was embolized with coils and/or vascular plugs. Liver volumes were calculated at baseline, following PVE, and following HVE, in order to assess the hypertrophic effect of PVE and HVE on the FLR. Nine patients underwent HVE (n = 3, right HVE; n = 6, middle HVE) because of inadequate FLR hypertrophy following PVE. The standardized FLR increased from 0.16 (median, range 0.08-0.24) at baseline to 0.22 (median, range 0.13-0.29) following PVE (p = 0.0005) to 0.26 (median, range 0.19-0.37) following HVE (p = 0.0050). HVE was performed 40 days (median, range 19-128 days) following PVE, and assessment of FLR hypertrophy was performed 41 days (median, range 19-92 days) following HVE. Four of nine patients underwent hepatectomy; 5 patients failed to undergo hepatectomy (n = 3, inadequate hypertrophy; n = 1, disease progression; n = 1, portal hypertension). One patient required repeat HV...Continue Reading

References

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May 17, 2018·European Radiology·Ulrika AsenbaumRichard Nolz

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Citations

Nov 23, 2020·Surgical Oncology Clinics of North America·Yoshikuni KawaguchiJean-Nicolas Vauthey
May 4, 2021·Annals of Surgical Oncology·Eduardo A VegaClaudius Conrad
Aug 29, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Mario GhosnJuan C Camacho

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