Foam sclerotherapy using polidocanol (aethoxysklerol) for pre-operative portal vein embolization

Abstract

Purpose: To evaluate the clinical safety and effectiveness of foam sclerotherapy using polidocanol for preoperative portal vein embolization (PVE) before lobectomy of the liver.Materials and Methods: From March 2006 to October 2008, foam sclerotherapy using polidocanol was performed in 16 patients [M:F=12:4, age range 48 - 75 years (mean, 62 years)] for PVE. The foam was composed of a 1:2:1 ratio of 3% polidocanol (Aethoxysklerol; Kreussler Pharma, Wiesbaden, Germany), room air, and contrast media (Xenetix; Guerbet, Aulnay-Sous-Bois, France). The total amount of polidocanol used (2 - 8 mL; mean, 4.6 mL) was varied according to the volume of the target portal vein. We calculated the volume of future liver remnant (FLR) before and after PVE and evaluated complications associated with the use of polidocanol foam sclerotherapy for PVE.Results: Technical success was achieved in all patients. All patients were comfortable throughout the procedure and did not experience pain during sclerotherapy. No peri-procedural morbidity or mortality occurred. Patients underwent a liver dynamic CT scan 2 - 4 weeks after PVE. FLR increased significantly after PVE using polidocanol foam from 19.3% (16-35%) before PVE to 27.8% (23-42%) after PVE (P=0.001).Conclusions: Foam sclerotherapy using polidocanol is clinically safe and effective for pre-operative PVE.