Early arterial stasis during resin-based yttrium-90 radioembolization: incidence and preliminary outcomes.

Piana PM, Bar V, Doyle L, Anne R, Sato T, Eschelman DJ, McCann JW, Gonsalves CF, Brown DB
HPB (Oxford). 2014 16 (4): 336-41

PMID: 23782387 · PMCID: PMC3967885 · DOI:10.1111/hpb.12135

OBJECTIVES - 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.

METHODS - 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.

RESULTS - 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%; P = 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 (P = 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 (P = 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 (P < 0.001). Rates of partial response and stable disease were similar in the stasis (88.3%) and non-stasis (76.0%) groups (P = NS).

CONCLUSIONS - 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.

© 2013 International Hepato-Pancreato-Biliary Association.

MeSH Terms (17)

Aged Brachytherapy Embolization, Therapeutic Female Humans Infusions, Intra-Arterial Liver Neoplasms Male Microspheres Middle Aged Radiopharmaceuticals Regional Blood Flow Retrospective Studies Risk Factors Time Factors Treatment Outcome Yttrium Radioisotopes

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