Percutaneous ipsilateral portal vein embolization using a modified four-lumen balloon catheter with fibrin glue: initial clinical experience

Gibo, Masaki; Unten, Shinobu; Yogi, Akira; Nakayama, Tadashi; Ayukawa, Yuichirou; Gibo, Shinji; Murayama, Sadayuki; M, Takara; Shiraishi, Masayuki

doi:10.1007/s11604-007-0120-z

Cited by 25 publications

(15 citation statements)

References 21 publications

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“…As the definition of the upper limit of normal PP was 15 cmH2O (approximately 11 mmHg), an estimated PP >11 mmHg was also thought to indicate an actual PP >11 mmHg. An actual PP >11 mmHg was observed in 17 patients (57%), whereas an estimated PP >11 mmHg was observed in The usefulness of IOUS has been well established, and IOUS is considered a reliable imaging technique that is often used to confirm the diagnosis of intrahepatic tumor lesions [3,4]. The advantages of IOUS Doppler were recently reported in patients undergoing hepatectomy [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

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Prediction of portal pressure from intraoperative ultrasonography

Nanashima

Abo

Arai

et al. 2014

Journal of Surgical Research

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Background: Portal hypertension is a major risk factor for hepatic failure or bleeding in patients who have undergone hepatectomy, but it cannot be measured indirectly. We attempted to evaluate the intra-operative ultrasonography parameters that correlate with portal pressure (PP) in patients undergoing hepatectomy. Methods:We examined 30 patients in whom portal pressure was directly measured during surgery. The background liver conditions included chronic viral liver disease in seven patients, chemotherapy associated steatohepatitis in four patients, fatty liver in one patient, hepatolithiasis in one patient, obstructive jaundice in one patient and a normal liver in 16 patients. A multivariate logistic analysis and linear regression analysis were conducted to develop a predictive formula for PP. Conclusion:This formula, which uses ultrasonographic Doppler flow parameters, appears to be useful for predicting portal pressure.

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Section: Discussionmentioning

confidence: 99%

“…Portal hypertension remains a lethal operative risk in patients with liver dysfunction, such as cirrhosis, and should be carefully evaluated [2]. However, portal pressure (PP) can be measured directly by the insertion of a catheter via a trans-hepatic or trans-intestinal venous approach [3,4].…”

Section: Introductionmentioning

confidence: 99%

Prediction of portal pressure from intraoperative ultrasonography

Nanashima

Abo

Arai

et al. 2014

Journal of Surgical Research

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“…Portal hypertension remains to be a lethal operative risk in patients with liver dysfunction such as cirrhosis and should be carefully evaluated on imaging analysis [2]. However, portal pressure (PP) can be measured directly by insertion of a catheter via a trans-hepatic or trans-intestinal venous approach [3]. This approach is an invasive and complicated measure, requiring either puncture of the liver or laparotomy.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Predictors of Portal Pressure from Functional Liver Reserve in Patients Who Underwent Hepatectomy

et al. 2014

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Portal hypertension is a major risk factor for hepatic failure or intestinal bleeding in patients with liver disease but cannot be measured indirectly. We attempted to comprehensively evaluate preoperative parameters of functional liver reserve that correlated with portal pressure (PP) in patients with various liver diseases. We examined 93 patients in whom portal pressure was directly measured during preoperative portal vein embolization (PVE) or operation. Background liver included chronic viral liver disease in 43 patients, obstructive jaundice in 29 patients, and normal liver in 21. Multivariate logistic analysis and linear regression analysis were applied to create a predictive formula for PP. Mean PP was 13.4±4.9 cm H 2 O, and PP was significantly associated with severity of liver injury, hepatic fibrosis, intraoperative blood loss, and post-hepatectomy morbidity (p<0.05 each). Mean PP after PVE (22.5±7.8 cm H 2 O) was significantly increased compared to that before embolization (13.1 ± 4.7 cm H 2 O; p<0.01). Univariate analysis identified seven significant parameters of preoperative liver function associated with PP: indocyanine green (ICG) test result, liver uptake and clearance index (HH15) on 99m Tc-galactosyl serum albumin liver scintigraphy, total bilirubin level, prothrombin activity, and hyaluronate level. Using multiple linear regression analysis, the predictive formula using ICG and HH15 was as follows: Y (estimated PP)=0.273+0.086×ICGR15+ 0.193×HH15. The calculated PP (11.5±4.6 cm H 2 O (−1.9 cm H 2 O)) was lower than true PP, which was significantly associated with post-hepatectomy morbidity (p<0.05). The correlation between true and calculated PP was weak, and prediction using the conventional liver functional parameters was limited at present and, however, estimating PP appears to be useful in evaluating portal hypertension and post-hepatectomy morbidity.

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“…However, the techniques and equipment used in such procedures, including the embolic agents [5][6][7][8][9][10][11][12][13][14][15], vary greatly among facilities [5][6][7][8][9][10][11][12][13][14][15]. The conventional agents include fibrin glue [2-4, 8, 12, 13], gelatin sponges [14,15], dehydrated ethanol (along with the concurrent use of metal coils) [6-9, 11, 13], and monoethanolamine oleate [10].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Percutaneous Transhepatic Portal Embolization with Dehydrated Ethanol

Hanaoka¹,

Banno²,

Kato³

et al. 2014

TOMIJ

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Purpose:The efficacy and safety of percutaneous transhepatic portal embolization (PTPE) with dehydrated ethanol was determined by measuring the liver lobe volume before and after the procedure. Materials and Methods:A total of 38 patients (25 men, 13 women; mean age: 62.0 ± 10.8 years) who underwent PTPE with dehydrated ethanol between April 2005 and March 2011 participated in this study. Dehydrated ethanol containing 17% lipiodol was injected into the target portal vein branch under balloon occlusion, and the portal vein was subsequently embolized. The liver lobe volume was measured via contrast-enhanced computed tomography, and the percent increase in the unembolized lobe volume was then calculated. In addition, PTPE-related complications were surveyed, and the procedural safety was evaluated. Results:The mean percent increase in the unembolized lobe volume after PTPE was 33.8% ± 20.2%. The procedure could not be completed in one patient because of an insufficient increase in the unembolized lobe volume. No serious post-PTPE complications were observed. Conclusion:These data suggest that PTPE with dehydrated ethanol is a safe and effective method for enlarging the planned residual liver volume before extensive liver resection.

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Percutaneous ipsilateral portal vein embolization using a modified four-lumen balloon catheter with fibrin glue: initial clinical experience

Cited by 25 publications

References 21 publications

Prediction of portal pressure from intraoperative ultrasonography

Prediction of portal pressure from intraoperative ultrasonography

Comprehensive Predictors of Portal Pressure from Functional Liver Reserve in Patients Who Underwent Hepatectomy

Efficacy and Safety of Percutaneous Transhepatic Portal Embolization with Dehydrated Ethanol

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