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Preoperative Portal Vein Embolization with a New Liquid Embolic Agent¹

¹ From the Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-Dong, Songpa-Ku, Seoul 138-736, Korea. From the 2001 RSNA scientific assembly. Received October 17, 2001; revision requested January 9, 2002; final revision received August 23; accepted August 27. Address correspondence to K.B.S. (e-mail: kbsung@amc.seoul.kr).

PURPOSE: To evaluate the effectiveness and safety of a new liquid embolic agent in preoperative portal vein embolization.

MATERIALS AND METHODS: Embol-78 was obtained by means of hydrolysis of polyvinyl acetate and was dissolved in a mixture of ethanol and nonionic water-soluble contrast medium. After percutaneous puncture of the portal vein, embolization of the right portal vein was performed in 22 patients with hepatocellular carcinoma and in 29 patients with nonhepatocellular carcinoma. In each group, changes in volume of the future liver remnant, portal venous pressure, and liver enzymes were evaluated both before and after embolization. Complications were also evaluated.

RESULTS: Portal vein embolization was successful in all patients, without major complications. The mean volumes of the future liver remnant before and 2 weeks after embolization were 385 mL ± 138 and 533 mL ± 140, respectively, in the hepatocellular carcinoma group and 517 mL ± 348 and 755 mL ± 197, respectively, in the nonhepatocellular carcinoma group. There were only transient elevations in liver enzyme levels after embolization. Mean portal venous pressures before and after the procedure were 16.7 mm Hg ± 3.8 and 20.3 mm Hg ± 3.6, respectively, in the hepatocellular carcinoma group and 11.7 mm Hg ± 3.5 and 14.6 mm Hg ± 3.6, respectively, in the nonhepatocellular carcinoma group. In each group, changes in volume of the future liver remnant and portal venous pressure were statistically significant (P < .001).

CONCLUSION: The liquid embolic material Embol-78 seems to be effective and safe for preoperative portal vein embolization.

© RSNA, 2003

Index terms: Liver, transplantation, 761.45 • Portal vein, stenosis or obstruction • Portal vein, therapeutic embolization, 957.1264

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