Preoperative Portal Vein Embolization in Hepatic Surgery: A Review about the Embolic Materials and Their Effects on Liver Regeneration and Outcome

Table 2

Embolic materials used for PVE: advantages and drawbacks.

Material	Main advantages	Drawbacks	Occlusion	Pain
Gelatin sponge	Easy handling; Low inflammation	Recanalization	Transient	Mild
PVA/MS plus coils/VP	Distal and proximal occlusion	Time consuming; more contrast and fluoroscopy time	Definitive	Mild
Fibrin glue	Robust hypertrophy	Very expensive; fatal emboli to the brain reported	Definitive	NR
NBCA-lipiodol	Best hypertrophy?; Cheap	Steeper learning curve	Definitive	Moderate to severe
Ethanol	Robust hypertrophy; Cheap	Occlusion balloon usually adopted	Definitive	Moderate to severe
Foam	Cheap	Recanalization; occlusion balloon adopted	Definitive	Mild
EVOH	Controlled administration	Many vials needed; very expensive; time consuming	Definitive	Moderate to severe

PVA: polyvinyl-alcohol particles; MS: microspheres; VP: vascular plug; NBCA: n-butyl-cyanoacrylate; EVOH: ethylene vinyl alcohol; NR: not reported; Some groups reported interruption of its use due to its elevated cost. There are reports of recanalization.