Single-Center Retrospective Study Comparing Double Vein Embolization via a Trans-Jugular Approach with Liver Venous Deprivation via a Trans-Hepatic Approach

Purpose: To compare safety, technical and clinical outcomes of double vein embolization (DVE) via a trans-jugular approach with liver venous deprivation (LVD) via a trans-hepatic approach.Materials and MethodsA single-center retrospective analysis was conducted on patients undergoing simultaneous portal and hepatic veins embolization in view of a major hepatectomy (June 2019-November 2022). Hepatic vein embolization was performed either by transjugular plug (DVE) or by transhepatic plug followed by glue injection (LVD). Inclusion criteria were availability of pre-procedural CT scan, and availability of CT scans acquired 10 days and 25 days post-procedure. Comparative data included complication rate, fluoroscopy time, dose area product (DAP), Future Liver Remnant volume and function increase (FLR-V and FLR-F increase, respectively) and clinical outcomes.ResultsThirty-six patients (n = 14 DVE; n = 22 LVD) were included. No baseline significant differences were observed among the two groups. One grade-3 complication (2.8%) was observed in the LVD group; one case of technical failure (2.8%) was observed in the DVE group. Fluoroscopy time and DAP were similar between DVE and LVD (29 +/- 17.7 vs. 25 +/- 8.2 min, p = 0.97; 105.1 +/- 63.5 vs. 143.4 +/- 79.5 Gy center dot cm2, p = 0.15). No differences arose at either time-point in FLR-V increase (46.7 +/- 23.1% vs. 48.2 +/- 28.2%, 52.9 +/- 30.9% vs. 53.2 +/- 29%, respectively, p = 0.9). FLR-F increase also did not differ significantly (62.8 +/- 55.2 vs. 67.4 +/- 57.5, p = 0.9). No differences in drop-out rate from surgery were observed. (28.6% vs. 27.3%, p = 0.93). One case of grade-B post-hepatectomy liver failure (2.8%) was observed in the LVD group.ConclusionLVD via transhepatic approach and DVE via transjugular approach seem equally safe and effective.Level of Evidence Level 3, Retrospective Cohort Study.ConclusionLVD via transhepatic approach and DVE via transjugular approach seem equally safe and effective.Level of Evidence Level 3, Retrospective Cohort Study.