Hepatic artery embolization video
December 11, 2008 § 1 Comment
This is a minimally-invasive procedure to purposely occlude selected branches of the hepatic artery. In this specific video the procedure is done to reduce the amount of liver metastasis in a patient with a metastatic neuroendocrine tumor of the pancreas.
The interventional radiologist opens the patient’s femoral artery and introduces a guidewire into the artery. A catheter is then threaded over the guidewire and slowly moved up to the hepatic artery via the external and common iliac artery, abdominal aorta and celiac trunk. This is done guided by live x-ray and angiography with intraarterial contrast.
When the correct branch of the hepatic artery is located, a microcathether is introduced into the catheter and moved into the smaller arterial branches. In this video it is the right lobe of the liver that is treated. Polyvinyl alcohol particles are mixed with a contrast agent and injected through the microcathether. When injected the particles occlude the blood vessels and thus block blood supply to the metastatic tumors.
At the end of the video a CAT scan from 6 months after the embolization shows significant shrinkage of the tumors in the right lobe. In the left lobe, which for medical reasons was not embolized, the metastatic tumors have grown.
PS. The x-ray system in the room where I filmed this video was a bit old, and did not have a proper video output that I could record. To capture the live x-ray and angiography I had to film the screens the radiologist was watching. A very suboptimal approach. I’ll hopefully get the chance to update the video with properly recorded x-ray footage sometime soon.