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Prophylactic Temporary Occlusion of the Cystic Artery Using a Fibered Detachable Coil During 90Y Radioembolization

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Abstract

Purpose

To address the feasibility of prophylactic temporary occlusion of the cystic artery using a detachable coil during 90Y radioembolization.

Materials and Methods

From January 2012 to October 2016, nine patients underwent temporary occlusion of the cystic artery during 90Y radioembolization. Based on the planning hepatic angiography, a detachable coil was deployed into the cystic artery, which arose from a more distal level (e.g., right anterior hepatic artery) than its usual origin, but the proximal 1 cm was left inside the microcatheter. 90Y microspheres were infused proximal to the cystic artery where the 99mTc-MAA had been infused, and then the coil was retrieved. Afterward, the patients underwent PET/CT imaging. Medical records were reviewed, and the differences in the uptake of 99mTc-MAA and 90Y microspheres in the gallbladder were evaluated using Wilcoxon’s signed-rank test.

Results

Temporary placement of a detachable coil was feasible in all cases. On the angiograms obtained after detachable coil placement, the distal cystic artery and gallbladder were partially identifiable in eight of the nine (88.8%) patients, but fully restored after the removal of the coils in all cases. The proportional uptake of 99mTc-MAA (mean, 4.35%) and 90Y (mean, 0.90%) in the gallbladder was significantly different due to the temporary occlusion of the cystic artery (p = 0.004). No clinical complications were identified for three months after the procedure.

Conclusion

Temporary occlusion of the cystic artery using a detachable coil appeared to be feasible and effective in reducing 90Y uptake in the gallbladder.

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Author information

Author notes

  1. Jin Woo Choi and Min Young Yoo have contributed equally to this work.

Authors and Affiliations

  1. Section of Interventional Radiology, Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea

    Jin Woo Choi, Hyo-Cheol Kim & Jin Wook Chung

  2. Department of Nuclear Medicine, Chungbuk National University Hospital, Cheongju, South Korea

    Min Young Yoo

  3. Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea

    Min Young Yoo & Jin Chul Paeng

  4. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea

    Yoon Jun Kim

Authors
  1. Jin Woo Choi
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  2. Min Young Yoo
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  3. Hyo-Cheol Kim
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  4. Jin Chul Paeng
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  5. Yoon Jun Kim
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  6. Jin Wook Chung
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Corresponding author

Correspondence to Hyo-Cheol Kim.

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All authors declare that they have no conflicts of interest.

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Choi, J.W., Yoo, M.Y., Kim, HC. et al. Prophylactic Temporary Occlusion of the Cystic Artery Using a Fibered Detachable Coil During 90Y Radioembolization. Cardiovasc Intervent Radiol 40, 1624–1630 (2017). https://doi.org/10.1007/s00270-017-1688-z

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  • DOI: https://doi.org/10.1007/s00270-017-1688-z

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