Comparison of Embolic Agents in Portal Vein Embolization between STS Foam and Microspheres with Coils: A Single Institution Experience
22 March 2018 (online)
Purpose Calculation of the future liver remnant (FLR) can guide the decision to proceed to resection in patients with primary and secondary hepatic malignancies. Portal vein embolization (PVE) hypertrophies the liver remnant for surgery. To our knowledge, no study has demonstrated the superiority of one embolic agent over another. The purpose of our analysis is to compare sodium tetradecyl sulfate (STS) foam to our standard embolic combination of coils and microparticles.
Materials and Methods A retrospective, institutional review board (IRB) approved analysis of all patients who received right PVE between December 2013 and May 2017 was performed (n = 13; 11 males and 2 females, mean age: 52.2 years). Nine patients underwent embolization with coils/particles and four with STS. Data for fluoroscopy time, material cost, pre- and post-embolization FLR, and complications were gathered.
Results Mean fluoroscopy time was less for the STS group (20.3 min versus 44.9 min) as compared with coil and particle group, (p = 0.01). Mean material cost was less for the STS group ($173.40 versus $4,365.19), (p = 0.02). Mean hypertrophy in FLR after embolization was not statistically significant: 31.1% for the STS group and 20% for the non-STS group, (p = 0.44). Only one major complication occurred, and this was in the non-STS group.
Conclusion Given our small sample size, PVE with STS appears to be superior to embolization with coils and particles with regard to procedure time and material cost. STS is equal in efficacy and safety to our standard embolization technique.