Early arterial stasis during resin‐based yttrium‐90 radioembolization: incidence and preliminary outcomes. Issue 4 (19th June 2013)

• Record Type: Journal Article
• Authors: Piana, Peachy Mae; Bar, Voichita; Doyle, Laura; Anne, Rani; Sato, Takami; Eschelman, David J.; McCann, Jeffrey W.; Gonsalves, Carin F.; Brown, Daniel B.
• Is Part Of: HPB. Volume 16:Issue 4(2014:Apr.)
• Page Start: 336
• Page End: 341
• Publication Date: 2013-06-19
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/hpb.12135
• Languages: English
• ISSNs: 1365-182X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hpb12135-sec-0001" sec-type="section"> <title>Objectives</title> <p>This study was conducted to determine the incidence of early stasis in radioembolization using resin yttrium‐90 (Y‐90) microspheres, to evaluate potential contributing factors, and to review initial imaging outcomes.</p> </sec> <sec id="hpb12135-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients in whom early stasis occurred were compared with those in whom complete delivery was achieved for tumour type and vascularity, tumour : normal liver ratio (T : N ratio) at technetium‐99m‐macroaggregated albumin (Tc‐99m‐MAA) angiography, previous intra‐arterial therapy, and infusion site (left, right or whole liver). Tumour response was evaluated at 3 months and defined according to whether a partial response and stable disease versus progressive disease were demonstrated.</p> </sec> <sec id="hpb12135-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 71 patients underwent 128 Y‐90 infusions in which 26 (20.3%) stasis events occurred. Hypervascular and hypovascular tumours had similar rates of stasis (17.4% versus 27.8%; <italic>P</italic> = NS). The mean ± standard deviation T : N ratio was 3.03 ± 1.54 and 3.66 ± 2.79 in patients with and without stasis, respectively (<italic>P</italic> = NS). Stasis occurred in 14 of 81 (17.3%) and 12 of 47 (25.5%) infusions following previous intra‐arterial therapy and in therapy‐naïve territories, respectively (<italic>P</italic> = NS). Early stasis occurred in 15 of 41 (36.6%) left, 10 of 65 (15.4%) right and one of 22 (4.5%) whole liver infusions (<italic>P</italic> < 0.001). Rates of partial response and stable disease were similar in the stasis (88.3%) and non‐stasis (76.0%) groups (<italic>P</italic> = NS).</p> </sec> <sec id="hpb12135-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Early stasis occurred in approximately 20% of infusions with similar incidences in hyper‐ and hypovascular tumours. Whole‐liver therapy reduced the incidence of stasis. Stasis did not appear to affect initial imaging outcomes.</p> </sec> </abstract>