Jaberi Arash, Toor Sundeep S, Rajan Dheeraj K, Mironov Oleg, Kachura John R, Cleary Sean P, Smoot Rory, Tremblay St-Germain Amélie, Tan Kongteng
Division of Vascular and Interventional Radiology, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada.
Department of Diagnostic Imaging , Markham Stouffville Hospital, Markham, Ontario, Canada.
J Vasc Interv Radiol. 2016 Dec;27(12):1897-1905.e1. doi: 10.1016/j.jvir.2016.05.023. Epub 2016 Jul 18.
To report outcomes after portal vein embolization (PVE) and right hepatectomy in patients receiving embolization with N-butyl cyanoacrylate (NBCA) glue + central AMPLATZER Vascular Plug (AVP; glue group) or polyvinyl alcohol (PVA) particles ± coils (PVA group).
Between March 2008 and August 2013, all patients having PVE with NBCA + AVP or PVA ± coils before right hepatectomy were retrospectively reviewed; 85 patients underwent PVE with NBCA + AVP (n = 45) or PVA ± coils (n = 40). The groups were compared using Mann-Whitney U and χ tests.
Technical success of embolization was 100%. Degree of hypertrophy (16.2% ± 7.8 vs 12.3% ± 7.62, P = .009) and kinetic growth rate (3.5%/wk ± 2.0 vs 2.6%/wk ± 1.9, P = .016) were greater in the glue group versus the PVA group. Contrast volume (66.1 mL ± 44.8 vs 189.87 mL ± 62.6, P < .001) and fluoroscopy time (11.2 min ± 7.8 vs 23.49 min ± 11.7, P < .001) were significantly less during the PVE procedure in the glue group. Surgical outcomes were comparable between groups, including the number of patients unable to go onto surgery (P = 1.0), surgical complications (P = .30), length of hospital stay (P = .68), and intensive care unit admissions (P = .71). There was 1 major complication (hepatic abscess) in each group after PVE.
PVE performed with NBCA + AVP compared with PVA ± coils resulted in greater degree of hypertrophy of the future liver remnant, less fluoroscopic time and contrast volume, and similar complication rates.
报告接受氰基丙烯酸正丁酯（NBCA）胶+中心型Amplatzer血管塞（AVP；胶组）或聚乙烯醇（PVA）颗粒±弹簧圈（PVA组）栓塞的患者门静脉栓塞（PVE）及右肝切除术后的结果。
回顾性分析2008年3月至2013年8月期间，所有在右肝切除术前接受NBCA+AVP或PVA±弹簧圈PVE的患者；85例患者接受了NBCA+AVP（n = 45）或PVA±弹簧圈（n = 40）的PVE。采用Mann-Whitney U检验和χ检验对两组进行比较。
栓塞技术成功率为100%。胶组的肥大程度（16.2%±7.8 vs 12.3%±7.62，P = 0.009）和动态生长率（3.5%/周±2.0 vs 2.6%/周±- 1.9，P = 0.016）高于PVA组。胶组PVE过程中的造影剂用量（66.1 mL±44.8 vs 189.87 mL±62.6，P < 0.001）和透视时间（11.2分钟±7.8 vs 23.49分钟±11.7，P < 0.001）明显更少。两组手术结果相当，包括无法进行手术的患者数量（P = 1.0）、手术并发症（P = 0.30）、住院时间（P = 0.68）和重症监护病房收治情况（P = 0.71）。PVE后每组各有1例严重并发症（肝脓肿）。
与PVA±弹簧圈相比，采用NBCA+AVP进行PVE可使未来肝残余的肥大程度更高，透视时间和造影剂用量更少，并发症发生率相似。
