The factors that contribute to the effect of portal vein embolization before hepatectomy for hepatocellular carcinoma are unclear. Sixty-six patients with hepatocellular carcinoma were enrolled in the study. Changes in liver function, portal vein pressure, and liver volume after embolization were examined. A multiple linear regression analysis was performed to identify factors that independently contributed to the effects of portal vein embolization. The acceptable volume ratio of the remnant liver was calculated from liver function and compared with the volume ratio of the non-embolized liver. No postoperative deaths were observed after portal vein embolization or hepatectomy. Serum total bilirubin and prothrombin time did not change significantly after portal vein embolization. In patients who underwent arterial embolization before portal vein embolization, aminotransferase levels increased significantly. The only factor that could significantly predict the atrophy effects of portal vein embolization was previous arterial embolization. The volume ratio of the non-embolized liver was smaller than the acceptable volume ratio of the remnant liver in 18 of 40 patients and increased over the acceptable volume ratio in all cases after portal vein embolization. Portal vein embolization induced atrophy or hypertrophy of the embolized or non-embolized liver sufficiently, even when the liver was dysfunctional or cirrhotic. The atrophy effects were significant, especially when arterial embolization had been performed before portal vein embolization.
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http://dx.doi.org/10.1007/s00268-001-0189-y | DOI Listing |
Gastro Hep Adv
September 2024
Section of Vascular and Interventional Radiology, Department of Radiology, Northwestern University, Chicago, Illinois.
Portal vein recanalization transjugular intrahepatic portosystemic shunt (PVR-TIPS) is a safe and effective procedure for decompression of portal hypertension (PH). In this short case series, 2 women with chronic noncirrhotic portal vein thrombosis were treated with PVR-TIPS. Both patients hoped to conceive.
View Article and Find Full Text PDFCardiovasc Intervent Radiol
January 2025
Interventional Radiology, Hospital Sírio Libanês, São Paolo, Brazil.
Purpose: This study assesses the efficacy and safety of Portal Vein Recanalization with Intrahepatic Portosystemic Shunt (PVR-TIPS) in non-cirrhotic patients with chronic portal vein occlusion (CPVO), cavernomatous transformation, and symptomatic portal hypertension (PH) and/or portal vein thrombotic progression.
Material And Methods: Medical records of 21 non-cirrhotic patients with CPVO and portal cavernoma undergoing PVR-TIPS were analyzed. Hemodynamic (intraprocedural reduction in portosystemic pressure gradient), clinical (data on gastrointestinal bleeding, abdominal pain, ascites, and presence of esophageal varices from imaging exams) and technical success (PVR-TIPS) assessed efficacy.
Thromb Haemost
January 2025
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Background: Clot waveform analysis (CWA) provides a global assessment of hemostasis and may be useful for patients with cirrhosis with complex hemostatic abnormalities. This study aimed to assess the association between prothrombin time (PT-) and activated partial thromboplastin time (aPTT-) based CWA parameters and cirrhosis severity and prospectively evaluate the role of CWA in predicting mortality and acute decompensation (AD) over 1 year.
Methods: This prospective study included adult patients with cirrhosis between June 2021 and December 2023 at Chulalongkorn University Hospital.
J Biomech
January 2025
Department of Gastroenterology and Hepatology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, PR China. Electronic address:
Portal hypertension (PH) is the initial and main consequence of liver cirrhosis. Hepatic venous pressure gradient (HVPG) measurement has been widely used to estimate portal pressure gradient (PPG) and detect portal hypertension. However, some clinical studies have found poor correlation between HVPG and PPG, which may lead to the misdiagnosis of portal hypertension.
View Article and Find Full Text PDFHepatol Int
January 2025
Department of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510062, China.
Background/objective: The treatment strategy for hepatocellular carcinoma (HCC) with Vp4 (main trunk) portal vein tumor thrombosis (PVTT) remains controversial due to the dismal prognosis. We aimed to investigate the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) plus lenvatinib and tislelizumab in these patients.
Methods: This multicenter retrospective study included treatment-naive HCC patients with Vp4 PVTT from 2017 to 2022.
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