Assessing Intra-arterial Complications of Planning and Treatment Angiograms for Y-90 Radioembolization

Journal Article · Mon May 15 00:00:00 EDT 2017 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-016-1555-3· OSTI ID:22645223

Ahmed, Osman ^[1]; Patel, Mikin V. ^[2]; Masrani, Abdulrahman; Chong, Bradford; Osman, Mohammed; Tasse, Jordan; Soni, Jayesh; Turba, Ulku Cenk; Arslan, Bulent ^[1]

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1. Rush University Medical Center, Section of Interventional Radiology, Department of Radiology (United States)
2. University of Chicago, Department of Radiology (United States)

PurposeTo report hepatic arterial-related complications encountered during planning and treatment angiograms for radioembolization and understand any potential-associated risk factors.Materials and Methods518 mapping or treatment angiograms for 180 patients with primary or metastatic disease to the liver treated by Yttrium-90 radioembolization between 2/2010 and 12/2015 were retrospectively reviewed. Intra-procedural complications were recorded per SIR guidelines. Patient demographics, indication for treatment, prior exposure to chemotherapeutic agents, operator experience, and disease burden were reviewed. Technical variables including type of radioembolic (glass vs. resin microspheres), indication for angiography (mapping vs. treatment), variant anatomy, and attempts at coil embolization were also assessed.ResultsThirteen (13/518, 2.5%) arterial-related complications occurred in 13 patients. All but two complications resulted during transcatheter coil embolization to prevent non-target embolization. Complications included coil migration (n = 6), arterial dissection (n = 2), focal vessel perforation (n = 2), arterial thrombus (n = 2), and vasospasm prohibiting further arterial sub-selection (n = 1). Transarterial coiling was identified as a significant risk factor of complications on both univariate and multivariate regression analysis (odds ratio 7.8, P = 0.004). Usage of resin microspheres was also a significant risk factor (odds ratio 9.5, P = 0.042). No other technical parameters or pre-procedural variables were significant after adjusting for confounding on multivariate analysis (P > 0.05).ConclusionIntra-procedural hepatic arterial complications encountered during radioembolization were infrequent but occurred mainly during coil embolization to prevent non-target delivery to extra-hepatic arteries.

• OSTI ID: 22645223
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 40, Issue 5; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANATOMY
ARTERIES
BIOMEDICAL RADIOGRAPHY
CONTAINERS
DELIVERY
GLASS
HAZARDS
LIVER
MAPPING
MATERIALS
METASTASES
MICROSPHERES
MIGRATION
MULTIVARIATE ANALYSIS
PATIENTS
PERFORATION
PLANNING
POTENTIALS
RADIOEMBOLIZATION
RECOMMENDATIONS
REGRESSION ANALYSIS
RESINS
REVIEWS
VASCULAR DISEASES
YTTRIUM
YTTRIUM 90