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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.

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.

journal_name

Eur Radiol

journal_title

European radiology

authors

Pieper CC,Willinek WA,Thomas D,Ahmadzadehfar H,Essler M,Nadal J,Wilhelm KE,Schild HH,Meyer C

doi

10.1007/s00330-015-4076-6

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

2779-89

issue

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-015-4076-6

journal_volume

pub_type

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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.