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Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have?
PURPOSE: To examine if the addition of a central vascular plug (CVP) to portal vein embolization (PVE) with N-butyl cyanoacrylate-glue (NBCA) increases future liver remnant (FLR) growth. MATERIAL AND METHODS: This is a single-center retrospective study of 115 consecutive patients with colorectal liv...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940786/ https://www.ncbi.nlm.nih.gov/pubmed/34907454 http://dx.doi.org/10.1007/s00270-021-03014-w |
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author | Carling, Ulrik Røsok, Bård Berger, Sigurd Fretland, Åsmund Avdem Dorenberg, Eric |
author_facet | Carling, Ulrik Røsok, Bård Berger, Sigurd Fretland, Åsmund Avdem Dorenberg, Eric |
author_sort | Carling, Ulrik |
collection | PubMed |
description | PURPOSE: To examine if the addition of a central vascular plug (CVP) to portal vein embolization (PVE) with N-butyl cyanoacrylate-glue (NBCA) increases future liver remnant (FLR) growth. MATERIAL AND METHODS: This is a single-center retrospective study of 115 consecutive patients with colorectal liver metastases undergoing PVE in 2013–2019. All patients were embolized with NBCA as the main embolic agent. In 2017–2019 NBCA was combined with a CVP in the central part of the right portal vein. Growth of the FLR and standardized FLR (sFLR) including degree of hypertrophy (DH) and kinetic growth rate (KGR) were analyzed, as well as procedure data such as use of cone-beam CT (CBCT), dose area product (DAP), fluoroscopy time and contrast dose. RESULTS: A total of 40 patients (35%) underwent PVE with a combination of CVP and NBCA. The DH was higher in these patients after 4 weeks, mean 13.6% (SD 7.8) vs. 10.5% (SD 6.4; p = 0.022), verified in multivariate analysis (coefficient 4.1, p = 0.015). A CVP did not significantly increase the resection rate (90% vs 82%, p = 0.4). Cone beam CT was used in 65 patients (57%). Use of CBCT did not affect FLR growth, and fluoroscopy time and contrast doses were not different in patients having a CBCT or not. Slightly lower DAP (median 3375 vs. 4499 cGy*cm(2); p = 0.09) was seen in procedures where CBCT was used. CONCLUSION: A CVP in addition to NBCA embolization was associated with increased growth of the FLR compared to NBCA alone. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00270-021-03014-w. |
format | Online Article Text |
id | pubmed-8940786 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-89407862022-04-07 Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have? Carling, Ulrik Røsok, Bård Berger, Sigurd Fretland, Åsmund Avdem Dorenberg, Eric Cardiovasc Intervent Radiol Clinical Investigation PURPOSE: To examine if the addition of a central vascular plug (CVP) to portal vein embolization (PVE) with N-butyl cyanoacrylate-glue (NBCA) increases future liver remnant (FLR) growth. MATERIAL AND METHODS: This is a single-center retrospective study of 115 consecutive patients with colorectal liver metastases undergoing PVE in 2013–2019. All patients were embolized with NBCA as the main embolic agent. In 2017–2019 NBCA was combined with a CVP in the central part of the right portal vein. Growth of the FLR and standardized FLR (sFLR) including degree of hypertrophy (DH) and kinetic growth rate (KGR) were analyzed, as well as procedure data such as use of cone-beam CT (CBCT), dose area product (DAP), fluoroscopy time and contrast dose. RESULTS: A total of 40 patients (35%) underwent PVE with a combination of CVP and NBCA. The DH was higher in these patients after 4 weeks, mean 13.6% (SD 7.8) vs. 10.5% (SD 6.4; p = 0.022), verified in multivariate analysis (coefficient 4.1, p = 0.015). A CVP did not significantly increase the resection rate (90% vs 82%, p = 0.4). Cone beam CT was used in 65 patients (57%). Use of CBCT did not affect FLR growth, and fluoroscopy time and contrast doses were not different in patients having a CBCT or not. Slightly lower DAP (median 3375 vs. 4499 cGy*cm(2); p = 0.09) was seen in procedures where CBCT was used. CONCLUSION: A CVP in addition to NBCA embolization was associated with increased growth of the FLR compared to NBCA alone. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00270-021-03014-w. Springer US 2021-12-14 2022 /pmc/articles/PMC8940786/ /pubmed/34907454 http://dx.doi.org/10.1007/s00270-021-03014-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Clinical Investigation Carling, Ulrik Røsok, Bård Berger, Sigurd Fretland, Åsmund Avdem Dorenberg, Eric Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have? |
title | Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have? |
title_full | Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have? |
title_fullStr | Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have? |
title_full_unstemmed | Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have? |
title_short | Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have? |
title_sort | portal vein embolization using n-butyl cyanoacrylate-glue: what impact does a central vascular plug have? |
topic | Clinical Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940786/ https://www.ncbi.nlm.nih.gov/pubmed/34907454 http://dx.doi.org/10.1007/s00270-021-03014-w |
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