Go back
Title: N-butyl cyanoacrylate vs vascular plug-N-butyl cyanoacrylate combination as embolic agent for pre-operative portal vein embolization: A randomized controlled trial. (interim results)
e-poster Number: EPOS 22
Category: e Poster
Author Name: Dr. Tara Prasad Tripathy
Institute:
Co-Author Name:
Abstract :
AIMS & OBJECTIVES: In patients with liver cancer, portal vein embolization (PVE) is recommended to promote liver growth before major hepatectomies. However, the optimal embolization strategy has not been established. To compare liver regeneration as seen at CT in participants with liver cancer, before major hepatectomies, with vascular plug-N-butyl cyanoacrylate (NBCA) combination versus standard N-butyl cyanoacrylate (NBCA), for PVE.
Materials and Methods: In this single-centre, prospective, randomized controlled trial (Best embolic PVE trial; CTRI/2024/09/073588), Vascular plug-N-butyl cyanoacrylate (NBCA) combination was compared with standard N-butyl cyanoacrylate (NBCA) in participants with liver cancer. Participant recruitment started in march 2024. Participants were randomly assigned to undergo PVE with Vascular plug-NBCA combination (Group 1) or PVE with NBCA plus iodized oil (Group 2). The primary end point was liver growth assessed with CT at 28 days after PVE. Secondary outcomes included post hepatectomy liver failure, amount of NBCA, fluoroscopic time for procedure, radiation dose, safety. The Mann-Whitney U test was used to compare continuous outcomes according to PVE material, whereas the x2 test or Fisher exact test was used for categoric variables.
Results: Ten participants were assigned each to Group 1 and Group 2 respectively. Interim analysis revealed superior liver hypertrophy for the group 1 (absolute hypertrophy of 46% vs 30% [P = .001]). Liver growth for the proposed hepatectomy was achieved in 70% of participants (7/10) in group 1 versus 60% of participants (6/10) in group 2 (P> 0.05) 28 days after PVE. Liver failure occurred in 10% of participants (1/10) in group 1 and in 30% of participants (3/10) in the group 2 (P = .27). The amount of NBCA, fluoroscopic time for procedure and radiation dose was similar in both groups. Imaging wise complete proximal occlusion was seen in Group 1 (10/10) whereas partial recanalization was present in 40% (4/10) in group 2. Clinically insignificant glue in left lobe reported on follow up CT present in 0/10 cases in group 1 whereas 2/10 in group 2. No major complication post PVE in either groups.
Conclusion: PVE with vascular plug-NBCA produced better liver growth as seen on CT in participants with liver cancer, compared with PVE with NBCA alone, with greater safety margin.
