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European Radiology
Published in: European Radiology 8/2016

01-08-2016 | Hepatobiliary-Pancreas

Incidence and risk factors of early arterial blood flow stasis during first radioembolization of primary and secondary liver malignancy using resin microspheres: an initial single-center analysis

Authors: Claus Christian Pieper, Winfried A. Willinek, Daniel Thomas, Hojjat Ahmadzadehfar, Markus Essler, Jennifer Nadal, Kai E. Wilhelm, Hans Heinz Schild, Carsten Meyer

Published in: European Radiology | Issue 8/2016

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Abstract

Objectives

To retrospectively determine incidence of early arterial blood flow stasis and its influencing factors during resin-based radioembolization (RE) of liver tumours.

Methods

Data of patients undergoing resin-based RE from 06/2006–12/2013 were reviewed. Second RE procedures of the same liver lobe were excluded. 90-yttrium dose was calculated according to the body surface area method. Data were categorized according to RE without full dose application because of early stasis and with full dose application. Clinical/procedural characteristics were recorded. Logistic regression was performed to identify associations between clinical/procedural characteristics and early stasis.

Results

362 patients [220 male; mean age 62 years (range 26–90)] underwent 416 RE sessions with early stasis occurring in 103 REs (24.8 %). Highest incidence and degree of stasis were observed in breast cancer metastases [42.6 % (20/47); 55.8 % of mean intended dose administered]. Independent risk factors were: metastasized breast cancer (odds ratio [OR] 2.18, p = 0.02), liver tumour-burden <25 % and 25–50 % (ORs 5.33, 15.64; p < 0.0001), tumour hypovascularity (OR 2.70, p = 0.04), previous bevacizumab therapy (OR 2.79, p = 0.0009) and concurrent chemotherapy (OR 8.69, p < 0.0001).

Conclusion

Early stasis was observed in 24.8 % of resin-based REs. In the presence of the identified risk factors, extra care should be taken during microsphere administration.

Key Points

• Early arterial blood flow stasis is a known problem of resin-based RE.
• The study showed that early stasis occurs in 25 % of REs.
• Several clinical and procedural factors are associated with early stasis.
• In patients at risk extra care should be taken during RE.
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Metadata
Title
Incidence and risk factors of early arterial blood flow stasis during first radioembolization of primary and secondary liver malignancy using resin microspheres: an initial single-center analysis
Authors
Claus Christian Pieper
Winfried A. Willinek
Daniel Thomas
Hojjat Ahmadzadehfar
Markus Essler
Jennifer Nadal
Kai E. Wilhelm
Hans Heinz Schild
Carsten Meyer
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4076-6

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