EMBOLIZATION THERAPY: Principles and Clinical Applications by Guimaraes Marcelo & Lencioni Riccardo & Siskin Gary

Author:Guimaraes, Marcelo & Lencioni, Riccardo & Siskin, Gary
Language: eng
Format: epub, pdf
ISBN: 9781451191448
Publisher: LWW
Published: 2014-12-01T05:00:00+00:00

Miscellaneous Benign Liver Diseases

Polycystic Liver Disease

Polycystic liver is the most common extrarenal manifestation associated with autosomal dominant polycystic kidney disease (ADPKD), presenting in 80% of all ADPKD patients.50 Most patients are asymptomatic and require no treatment. However, because of lengthened lifespan of ADPKD patients, recent patients often suffer from hepatic symptoms including abdominal discomfort, dyspepsia, or dyspnea. Surgical interventions to relieve these symptoms include laparoscopic or open cyst fenestration, partial hepatectomy, and hepatic transplantation.51,52 However, these treatments are associated with significant morbidity and mortality, reported as high as 42%.53 Recently, Ubara et al.54 suggested that TAE may be an option for symptomatic patients who are not candidates for surgical treatment. Hepatic cysts in ADPKD patients are mostly supplied from hepatic arteries; therefore, embolization of hepatic artery branches that supply major hepatic cysts may lead to shrinkage of the cyst (Fig. 33.3). Thereafter, several investigators embolized the hepatic arteries supplying the dominant hepatic segments replaced by cysts using microcoils55,56 or NBCA57 and achieved symptomatic relief in 50% to 86% of their patients. Total liver volume and intrahepatic cyst volume substantially decreased. No serious complications were reported except mild transient elevation of the liver enzyme.55–57

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