Portal vein embolization with N-butyl cyanoacrylate glue is superior to other materials: a systematic review and meta-analysis
2021 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 31, no 8, p. 5464-5478Article, review/survey (Refereed) Published
Abstract [en]
Objectives It remains uncertain which embolization material is best for portal vein embolization (PVE). We investigated the various materials for effectiveness in inducing future liver remnant (FLR) hypertrophy, technical and growth success rates, and complication and resection rates. Methods A systematic review from 1998 to 2019 on embolization materials for PVE was performed on Pubmed, Embase, and Cochrane. FLR growth between the two most commonly used materials was compared in a random effects meta-analysis. In a separate analysis using local data (n = 52), n-butyl cyanoacrylate (NBCA) was compared with microparticles regarding costs, radiation dose, and procedure time. Results In total, 2896 patients, 61.0 +/- 4.0 years of age and 65% male, from 51 papers were included in the analysis. In 61% of the patients, either NBCA or microparticles were used for embolization. The remaining were treated with ethanol, gelfoam, or sclerosing agents. The FLR growth with NBCA was 49.1% +/- 29.7 compared to 42.2% +/- 40 with microparticles (p = 0.037). The growth success rate with NBCA vs microparticles was 95.3% vs 90.7% respectively (p < 0.001). There were no differences in major complications between NBCA and microparticles. In the local analysis, NBCA (n = 41) entailed shorter procedure time and reduced fluoroscopy time (p < 0.001), lower radiation exposure (p < 0.01), and lower material costs (p < 0.0001) than microparticles (n = 11). Conclusion PVE with NBCA seems to be the best choice when combining growth of the FLR, procedure time, radiation exposure, and costs.
Place, publisher, year, edition, pages
Springer, 2021. Vol. 31, no 8, p. 5464-5478
Keywords [en]
Portal vein; Embolization; therapeutic; Enbucrilate; Hypertrophy; Radiation dosage
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-173466DOI: 10.1007/s00330-020-07685-wISI: 000611934100001PubMedID: 33501598Scopus ID: 2-s2.0-85099804995OAI: oai:DiVA.org:liu-173466DiVA, id: diva2:1530041
2021-02-202021-02-202022-05-23Bibliographically approved