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Portal vein embolization (PVE) is done to increase the size and function of the healthy part of the liver (future liver remnant) before major liver surgery. It is an important preoperative technique for minimising postoperative liver failure.This process guarantees that, following resection, the remaining liver can fulfil the body's metabolic needs.
You should see a specialist if you have a liver tumour that needs to be surgically removed, if a big liver resection is planned but the remaining liver volume is likely to be minimal, or if you have a liver mass with abnormal liver function tests. If you experience symptoms like chronic right upper abdomen pain, jaundice, unexplained weight loss, exhaustion, or appetite loss, you should also seek medical assistance.
PVE preparation consists of contrast CT/MRI with liver volumetry, and blood tests (CBC, LFT, RFT, PT/INR, hepatitis markers, patients may need to grant permission for contrast and interventional radiology procedures, stop taking blood thinners or antiplatelets, and fast for six to eight hours.
Portal Vein Embolization is performed in an interventional radiology suite:
- Both sedation and/or local anaesthesia are administered.
- A little skin incision is done to gain access to the portal vein system.
- Under imaging, a catheter is inserted into the branches that supply the area of the liver that needs to be removed.
- These portal vein branches are blocked by injecting embolic materials.
- Blood flow is diverted to the future liver remnant, which is the surviving liver.
- The puncture site is sealed when the catheter is removed.
- The patient's liver function, discomfort, and vital signs are tracked.
Depending on the anatomy and complexity of the liver, the treatment usually takes 60 to 120 minutes.Following the procedure, monitoring is done to make sure vital signs are stable and there are no problems right away.
PVE is generally safe but few possible complications may be arise:
- Fever or pain following embolisation
- Haematoma or bleeding at the puncture location
- An infection
- Contrast kidney strain or allergy (rare)
- Portal vein thrombosis: an uncommon but dangerous condition
- Malfunction of the liver, particularly in cirrhosis
- Rare non-target embolisation
- Nausea, fatigue and temporary loss of appetite
PVE has several benefits: increasing the amount of liver left over after surgery, reducing the risk of liver failure after hepatectomy, and raising the possibility that a major liver resection is safe are only a few advantages of PVE. It improves cancer patients' long-term surgery outcomes and is relatively less invasive than surgical alternatives.
After PVE, recovery typically happens quickly, with a hospital stay of one to three days and a few days of minor fever and gastrointestinal pain. Before undergoing final surgery, the majority of patients resume their regular activities in 5–10 days, and follow-up imaging in 2–6 weeks evaluates liver growth. Initially, heavy activity should be avoided and continuous monitoring should be maintained.
Effective liver enlargement can be achieved by portal vein embolisation; 70–90% of patients exhibit liver growth, and the majority of eligible patients develop sufficient hypertrophy to undergo scheduled liver surgery. The type and development rate of the tumour, the patient's functional and nutritional state, and liver health (healthy vs. cirrhotic) all influence overall success.
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Tel Aviv Sourasky Medical Center -Ichilov Hospital
Tel Aviv, Israel
Tel Aviv Sourasky Medical Center -Ichilov Hospital located in Tel-Aviv, Israel is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- The center possesses high end infratsructure with latest technologies which are upbgraded on a regular basis.
- There are 60 departments in Tel Aviv Sourasky Medical Center
- The center has as many as 6 institutions:
- Ichilov General Hospital
- Ted Arison Medical Tower
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- Adams Health Science & Rehabilitation Building (in the planning stage)
- Lis Maternity and Women's Hospital
- Patient Care Numbers (annual) are as follows:
- 400,000 patients
- 36,000 surgeries
- 220,000 ER visits
- 12,000 births
- The bed capacity of the center is 1300.
- Good success rates during treatment for the majority of conditions.
Max Smart Super Speciality Hospital
Delhi, India
3.9 ( 2 Reviews )
- Max Smart Super Speciality Hospital, Saket, New Delhi, is a 250-bed tertiary care hospital known for advanced medical technology and patient-centred care.
- The hospital offers services across 22+ specialities, including Cardiac Sciences, Orthopaedics, Urology, Neurology, Neurosurgery, Paediatrics, Obstetrics, and Gynaecology.
- It is a regional hub for complex procedures such as neurovascular interventions, targeted cancer treatments, heart surgeries, kidney and liver transplants, and bariatric care.
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Acibadem Kadikoy Hospital
Istanbul, Turkey
Acibadem Kadikoy Hospital located in Istanbul, Turkey is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- The number of beds in the hospital are 138 and Intensive Care beds are 23.
- There are as many as 6.500 access points for a building control system.
- There are 10 Operating theatres and more than 500 employees.
- There are specific healthcare facilities in Acibadem Kadikoy Hospital, Istanbul, Turkey which have been established per integrated healthcare outreach such as Breast Health Center, Check-up Center, and Diabetes Clinic etc.
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Apollo Hospital International Limited
Istanbul, Turkey
Acibadem Kozyatagi Hospital located in Istanbul, Turkey is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- The number of beds in the hospital are 84.
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- It is well known for the allied healthcare facilities such as a Radiotherapy Center, Use of innovative therapeutic equipment, Gamma Knife which makes for painless and non surgical treatment of tumors.
- The hospital is also recognised for its Motion Analysis Center for treating neurological and orthopaedic conditions and the stroke clinic as well.
- There are a number of free services provided by the Ac?badem Kozyata?? Hospital and these are outlined here,
- Online doctor consultation
- Medical records transfer
- Rehabilitation
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- Airport pickup
- Hotel booking
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- Pharmacy
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Sagrat Cor University Hospital
Barcelona, Spain
The Hospital is an amalgamation of a group of buildings located in the Eixample Left of Barcelona, ??between Paris, Viladomat, and London streets. It has a capacity of 350 adjustable beds and first-class hotel-like services inpatient rooms. Currently, it has a workforce of about 1100 Healthcare Professionals.
In order to treat patients with intensive care, the Hospital has 10 beds in its ICU for critically ill patients.
The Hospital has launched a few more things to improve customers’ services- 4 new Operating Rooms and a New Diagnostic Imaging Service.
Other Services
- Surgical Block with 13 major surgery operating rooms, 5 operating rooms for Minor Surgeries, 1 for Dermatology Service
- The Non-Admitted Surgery Unit (UCSI) Major Outpatient Surgery (CMA) has a total of 14 units to care for major surgery patients who do not require admission to hospitalization
- Rehabilitation Center with treatment boxes and group therapy room, Gym, Medical visit offices, priests rooms, waiting rooms, and others
- 7 Examination Cabinets
- The pediatric patients waiting room
- Emergency Center-12 emergency boxes, 1 double resuscitation box, and 7 rapid visit offices
Types of Room
Double Rooms, Double Rooms for Individual Use, and Single Rooms; equipped with an easy-to-use electrical movement control system and a nursing call/warning system, located at the head of the bed, a sofa-bed for the companion, and a bathroom with a shower. They are also equipped with television and telephone.
A cafeteria/Restaurant is also available for the patients or visitors.
Max Super Specialty Hospital, Shalimar Bagh
Delhi, India
- Max Super Speciality Hospital, Shalimar Bagh, is a 402-bed quaternary-care hospital in New Delhi, offering advanced treatment across 37+ specialities, including Cancer, Cardiac, Neurosciences, Gastroenterology, Orthopaedics, and Renal Transplant.
- Equipped with state-of-the-art technology and a team of highly skilled doctors and nurses, the hospital provides complex procedures, minimally invasive surgeries, and targeted cancer treatments, making it one of India’s leading healthcare destinations.
Rajagiri Hospital
Kochi, India
- Rajagiri Hospital, Kochi, Kerala, is a leading multi-speciality tertiary care hospital known for providing world-class medical services with advanced technology and compassionate care.
- Accredited by JCI, NABH, and NABL, the hospital offers comprehensive treatment across specialities like Cardiology, Oncology, Neurology, Gastroenterology, Orthopaedics, Nephrology, Urology, and Paediatrics, making it a trusted healthcare destination in South India.
Jaypee Hospital
Noida, India
Jaypee Hospital located in Noida, India is accredited by ISO, NABH, NABL. Also listed below are some of the most prominent infrastructural details:
- 525 beds in the first phase
- 150 Critical Care beds
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- 24 bedded Advanced Neonatal ICUs20 bedded Dialysis Units
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- 2 MRI (3.0 Tesla) with High-Intensity Focused Ultrasound
- 64 Slice PET CT, Gamma Camera, Dual Head 6 Slice SPECT CT
- 256 Slice CT Scan, CT Simulation
- Amongst the few GOLD LEED-certified hospital buildings in India
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- Wi-Fi/internet service in the room
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- Tele-consults after discharge
- Dedicated Guest House for International Patients maintained by Jaypee Hospital
- In-house translators for patient’s comfort
- Assistance in getting doctor’s opinion
- Registration with the Foreigners Regional Registration Office
- Accommodation arrangements after discharge
- Accommodation arrangement for the accompanying attendant
- Customized diet for patient and attendant
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- Prayer room
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- Advanced Laboratory facilities
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- High-end Ultrasound facilities
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+99Process Involved for Portal Vein Embolization (PVE)
- Assessment of liver volume and case selection
- Anaesthesia assessment and pre-procedure research
- Interventional radiologist's PVE procedure
- Monitoring following the surgery and managing discomfort and fever
- CT/MRI follow-up to assess hypertrophy
- Surgery to remove the liver after sufficient enlargement
- Hepatocellular cancer (HCC)
- Cancer of the cholangi
- Liver metastases from colorectal cancer
- Hepatectomy is necessary for large liver tumours.
- Some complicated benign tumours of the liver
There are various methods for carrying out PVE:
- Transhepatic portal vein embolisation via percutaneous means (most common)
- Trans-ileocolic PVE (infrequent, surgical entry)
- Depending on the architecture and resection plan, segmental or selective PVE
For treatment in {country}, patients may need:
- A valid passport and visa (for patients from abroad)
- Medical reports (biopsy, if performed, CT/MRI)
- Consent documents for interventions
- Approvals from insurance (if applicable)
PVE may be appropriate for a patient if:
- There will be a major liver resection.
- There is not enough future liver residual volume.
- Embolisation is acceptable for liver function.
- There is no serious coagulopathy or unchecked infection.
- Liver biopsy (in the event that the diagnosis is uncertain)
- Biliary drainage through the skin (if obstructive jaundice)
- In certain cancer instances, transarterial chemoembolization (TACE)
- Surgery to remove a significant portion of the liver (following PVE)
- Safer results from liver surgery
- Keeps the liver from failing following excision
- Faster recuperation with less invasiveness
- Can increase the number of surgical choices available to patients who were previously "not fit for resection."
After a successful PVE:
- The liver remnant grows in the future.
- In the remaining parts, liver function improves.
- A large hepatectomy becomes a safer option for the patient.
- The overall risk of surgery is greatly decreased.
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