WHAT IS PORTAL VEIN EMBOLISATION?
The portal vein brings nutrient-rich blood from the gastro-intestinal tract and the spleen to the liver. It is responsible for approximately 75% of the blood flow to the liver.
WHY EMBOLISE THE PORTAL VEIN?
In resecting tumours within the liver, surgeons can remove up to 70% of the liver safely, providing that there is no underlying liver impairment such as cirrhosis.
However, when the liver remnant is deemed to small to sustain life, this makes surgery impossible. Portal vein embolisation is a technique used to grow this liver remnant so that it will be able to sustain the patient once the liver that contains tumour is resected.
HOW IS THE PORTAL VEIN EMBOLISED?
A puncture is made into the portal vein through the patient’s skin, usually under ultrasound control. The venous supply to the tumour-containing liver is then carefully mapped out. These branches are then embolised/blocked with a medical “superglue” which forms a cast of the portal vein. In some cases, coils and small PVA particles may also be used.
WHAT HAPPENS AFTER PORTAL VEIN EMBOLISATION?
Blocking the portal vein supply to one side of the liver diverts blood to the other side of the liver, causing it to grow. This portion of liver will then be able to sustain the patient when the portion of the liver containing the tumour is removed. In essence, portal vein embolisation makes these “impossible” surgical candidates possible once more.