Feasibility of Endoscopic Ultrasound-guided Portal Vein Embolization with Enteryx
| Journal | Volume 68 - 2005 |
| Issue | Fasc.4 - Original articles |
| Author(s) | K. Matthes, D. Sahani, N. S. Holalkere, M. Mino-Kenudson, W. R. Brugge |
| Full article |
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| (1) Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA ; (2) Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA ; (3) Gastrointestinal Pathology Service, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. |
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Background : Portal vein embolization (PVE) has been used as a preoperative strategy to induce hepatic lobar atrophy and con- tralateral lobe hypertrophy. We determined the feasibility of endo- scopic ultrasound (EUS)-guided Enteryx (EVAL/ethylene-vinyl alcohol copolymer) embolization of the portal vein (EUS-PVE) in an animal model as a potential, minimally invasive, endoscopic technique. Methods : EUS-guided embolization of the portal vein (EUS- PVE) using Enteryx was performed in a Yorkshire breed swine. Portal pressure measurements were obtained before and after vas- cular embolization. The animal was carefully monitored for seven days for evidence of abdominal pain, shock, or bleeding. An upper abdominal contrast-CT scan was performed to verify the location of the embolus. Results : The PV pressure increased from 3 mmHg at baseline to a mean of 15 mmHg after EUS-PVE. The CT-scan on day 4 demonstrated Enteryx in the main portal vein with extension into the left branch. At sacrifice on day 7, a solid thrombus was visible grossly and histologically inside the main portal vein and the left branch of the portal vein. Conclusions : Selective embolization of the portal vein by EUS guidance appears to be feasible and a potential, minimally inva- sive, preoperative treatment option for patients undergoing exten- sive hepatectomy(Acta gastroenterol. belg., 2005, 68, 412-415). |
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© Acta Gastro-Enterologica Belgica. |
