Reduction of hepatic arterial flow by degradable microspheres in patients with liver tumor

Abstract

Ten patients with primary or secondary liver tumor were subjected to preoperative angiographic mapping of the hepatic circulation, combined with infusion of microspheres (Spherex Infusion). During laparotomy, 22 electromagnetic measurements of hepatic arterial flow were made and 2-40 ml of microspheres were infused at a rate of 2-16 ml per min over 1-4 min. Liver biopsies were taken. Hepatic arterial flow was reduced in a dose-dependent manner by a mean maximum of 67% following 8 ml at a rate of 2 ml per min. The reduction had a mean maximum duration of 10.4 min from end of infusion. At microscopy of liver specimens taken during maximum flow reduction, microspheres under degradation were seen. Angiography was of very limited value for estimating flow reduction. One patient experienced severe side-effects due to shunting. It appears rational to use microspheres together with cytostatics, provided that these are incorporated into hepatic tumor cells during a five min reduction by 50% of hepatic arterial blood flow.