Semin intervent Radiol 2008; 25(2): 155-161
DOI: 10.1055/s-2008-1076689
© Thieme Medical Publishers

Sequential Arterial and Portal Vein Embolization in Patients with Cirrhosis and Hepatocellular Carcinoma: The Hospital Beaujon Experience

Valérie Vilgrain1 , Annie Sibert1 , Magaly Zappa1 , Jacques Belghiti2
  • 1Department of Radiology, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, APHP, Clichy, France
  • 2Department of Hepatobiliary Surgery, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, APHP, Clichy, France
Further Information

Publication History

Publication Date:
30 May 2008 (online)

ABSTRACT

When feasible, hepatic resection is the treatment of choice for large hepatocellular carcinoma (HCC). Because HCC is often developed on chronic liver disease, which is known to have limited regeneration capacity, major hepatic resections are often contraindicated. Portal vein embolization (PVE) has been introduced to extend the indications for major hepatic resection and to increase the safety of the surgical procedure. However, hypertrophy after PVE is often less than in normal liver. It has been suggested that preoperative sequential arterial embolization and PVE have a strong anticancer effect and could increase the rate of hypertrophy more than PVE alone. In our experience, sequential arterial embolization and PVE effectively increase the future liver remnant and induce a high rate of complete tumor necrosis. This combined procedure should broaden the indication for major resection in chronic liver disease.

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Valérie VilgrainM.D. 

Department of Radiology, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris

APHP, 100 bd du Général Leclerc, 92110 Clichy, France

Email: valerie.vilgrain@bjn.aphp.fr