TY - JOUR
T1 - Preoperative Portal Vein Embolization
T2 - Indications and Technical Considerations
AU - de Baere, Thierry
AU - Denys, Alban
AU - Madoff, David C.
PY - 2007/3/1
Y1 - 2007/3/1
N2 - Preoperative portal vein embolization (PVE) has become an important tool in the management of select patients before major hepatic resection. PVE redirects portal flow to the intended future remnant liver (FRL) to induce hypertrophy of the nondiseased portion of the liver and thereby may reduce complications and shorten hospital stays after surgery. This article reviews the technical considerations for performing PVE including the use of the ipsilateral or contralateral approaches, how to choose a particular embolic agent for PVE, the importance of liver volumetric measurements to estimate functional hepatic reserve, the pathophysiology of PVE, and some of the results showing the benefit of the procedure. In addition, the indications and contraindications for performing PVE in patients with and without chronic liver disease, the use of combination therapies, and the concern for tumor growth after PVE will be discussed.
AB - Preoperative portal vein embolization (PVE) has become an important tool in the management of select patients before major hepatic resection. PVE redirects portal flow to the intended future remnant liver (FRL) to induce hypertrophy of the nondiseased portion of the liver and thereby may reduce complications and shorten hospital stays after surgery. This article reviews the technical considerations for performing PVE including the use of the ipsilateral or contralateral approaches, how to choose a particular embolic agent for PVE, the importance of liver volumetric measurements to estimate functional hepatic reserve, the pathophysiology of PVE, and some of the results showing the benefit of the procedure. In addition, the indications and contraindications for performing PVE in patients with and without chronic liver disease, the use of combination therapies, and the concern for tumor growth after PVE will be discussed.
KW - liver metastases
KW - liver primary tumors
KW - liver surgery
KW - portal vein embolization
UR - http://www.scopus.com/inward/record.url?scp=35548954130&partnerID=8YFLogxK
U2 - 10.1053/j.tvir.2007.08.003
DO - 10.1053/j.tvir.2007.08.003
M3 - Article
C2 - 17980321
AN - SCOPUS:35548954130
SN - 1089-2516
VL - 10
SP - 67
EP - 78
JO - Techniques in Vascular and Interventional Radiology
JF - Techniques in Vascular and Interventional Radiology
IS - 1
ER -