If you have primary liver cancer, or liver cancer that has metastasized from elsewhere in your body, portal vein embolization (PVE) may be part of your treatment. Northwestern Medicine offers care from a multidisciplinary team* that works closely with your referring physician to ensure you receive the best treatment to meet your needs. In addition, our clinical nurse coordinators assist in your planning, scheduling and follow-up after treatment.

Your liver is unique because it has two blood supplies. The portal vein provides 75 percent of your liver’s blood supply and the hepatic artery supplies the remaining 25 percent. Your liver also has the ability to regenerate itself if at least 30 percent of the organ remains intact after surgical removal of the diseased tissue. In the past, patients with large or multiple tumors were not considered suitable candidates for surgery because too much of their liver would need to be removed, severely compromising successful organ function.

PVE works by blocking, or embolizing, the flow of blood from the portal vein to the diseased portion of your liver, and redirecting that flow to the part of the liver that will remain after surgery. This blockage stimulates hypertrophy, or growth, of the non-embolized healthy liver segment, and causes the embolized, diseased portion of your liver to start to shrink. This helps ensure your surgeon can remove the maximum amount of disease from your liver during surgery.

PVE can increase your chances of being a candidate for surgical removal of liver cancer. The procedure is usually done as an outpatient, same-day procedure.

Benefits and risks

PVE offers several key benefits to you, including:

• It increases the chance your surgeon can completely remove the diseased portion of your liver during surgery
• PVE has the potential to reduce complications and shorten the number of days you stay in the hospital following liver resection surgery
• PVE can be repeated, if needed, before liver resection surgery to optimize the growth of the healthy portion of your liver

Risks following PVE include:

• Fever (short-term)
• Nausea and vomiting
• Fatigue
• Abdominal pain
• Infection or bleeding
• Blood clot forming in your portal vein, called portal vein thrombosis
• Small chance of the embolization material or particles becoming lodged in the wrong place and depriving normal tissue in your body of blood supply
• Allergic reaction to the contrast dye used for the X-ray
• Kidney damage for those with diabetes or pre-existing kidney disease

Potential side effects vary for every patient. Medications are given to help prevent or relieve most of these side effects. In addition, steps can be taken to prevent allergic reactions to contrast dye and lessen the chance of kidney damage for those at risk.