Five percent dextrose maximizes dose delivery of Yttrium-90 resin microspheres and reduces rates of premature stasis compared to sterile water.

Resin Yttrium-90 (Y90) microspheres have historically been infused using sterile water (HO). In 2013, recommendations expanded to allow delivery with 5% dextrose in water (DW). In this retrospective study, we hypothesized that DW would improve Y90 delivery with a lower incidence of stasis. We reviewed 190 resin Y90 infusions using HO (n=137) or DW (n=53). Y90 dosimetry was calculated using the body surface area method. Infusion was halted if intra-arterial stasis was fluoroscopically identified prior to clearing the vial. Differences between HO and DW groups were calculated for activity prescription, percentage of cases reaching stasis, and percentage delivery of prescribed activity using z- and t-test comparisons, with α=0.05. Thirty-one of 137 HO infusions developed stasis compared to 2 of 53 with DW (z=3.07, p=1.05E-03). DW also had a significantly higher prescribed activity than HO [28.2 millicuries (mCi) vs. 20.4 mCi, respectively; t=5.0, p=1.1E-6]. DW had a higher delivery percentage of the prescribed dose compared to HO (101.5 vs. 92.7%, respectively; t=3.8, p=1.92E-4). In conclusion, resin microsphere infusion utilizing DW has a significantly lower rate of stasis than HO and results in more complete dose delivery. DW is preferable to HO for resin microsphere infusion.