Preoperative portal venous and hepatic arterial embolization of tumor

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Although the goal of embolization is usually to create therapeutic ischemia or hemostasis without surgery, the rationale for preoperative embolotherapy is different in several respects. First, the aim is to prepare patients for definitive surgical resection rather than cure or palliation, and, thus, the goals and expectations are limited and defined by close communication between the interventionalist and the surgeon. Second, when considering segmental resection, the normal liver should be protected from procedural damage. Third, the search for extrahepatic disease is crucial for these patients because resection is typically abandoned in favor of alternative therapies for patients with systemic disease. Finally, intraoperative ultrasound should always be considered to survey the future liver remnant for unsuspected small tumors and allow ablation of these lesions to maximize the success of partial hepatectomy. This article describes preoperative hepatic arterial and portal venous embolization in patients with or without cirrhosis complicated by tumors judged eligible for surgical resection or orthotopic liver transplantation (OLT). Each type of embolization will be reviewed in terms of indications and contraindications, technique, and complications. Finally, the outcomes will be evaluated in terms of morbidity, mortality, and tumor recurrence rates.

Original languageEnglish (US)
Pages (from-to)242-251
Number of pages10
JournalSeminars in Interventional Radiology
Volume25
Issue number3
DOIs
StatePublished - Sep 1 2008
Externally publishedYes

Keywords

  • Liver cancer
  • Liver metastases
  • Liver surgery
  • Portal vein embolization
  • Transcatheter arterial chemoembolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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