Techniques in Vascular & Interventional Radiology
Volume 10, Issue 1 , Pages 67-78, March 2007

Preoperative Portal Vein Embolization: Indications and Technical Considerations

  • Thierry de Baere, MD

      Affiliations

    • Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, France.
    • Corresponding Author InformationAddress reprint requests to: Thierry de Baere, MD, Department of Interventional Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France.
    • ,
  • Alban Denys, MD

      Affiliations

    • Department of Radiology and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
    • ,
  • David C. Madoff, MD

      Affiliations

    • Division of Diagnostic Imaging, Interventional Radiology Section, The University of Texas M. D. Anderson Cancer Center, Houston, TX.

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.

Keywords: portal vein embolization, liver metastases, liver surgery, liver primary tumors

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PII: S1089-2516(07)00075-3

doi:10.1053/j.tvir.2007.08.003

Techniques in Vascular & Interventional Radiology
Volume 10, Issue 1 , Pages 67-78, March 2007

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