Percutaneous isolated liver perfusion with occlusion balloons and a catheter-based stent-graft-like perfusion device: an experimental study in a porcine model.

Abstract

OBJECTIVE: To evaluate the feasibility and safety of a novel percutaneous isolated liver perfusion (PILP) system in a porcine model. METHODS: The PILP catheter set, consisting of a portal vein and hepatic artery occlusion balloon and an hourglass-shaped vena cava stent-graft, was tested in six Dutch Landrace pigs. A veno-venous bypass between the distal portal vein and the right femoral vein, and isolated perfusion between the proximal portal vein and the hepatic veins were also created. Leak rate was determined using radioactivity measurement in the systemic circulation. Perfusion was then performed without (n = 2) or with cytotoxic drugs (n = 4). At the end of the procedure, all devices were retrieved and angiographic evaluation was performed of the involved vessel segments. RESULTS: In all pigs it was possible to insert, accurately position and retrieve all components of the PILP catheter set without angiographic signs of vessel-wall damage. Leakage rates to the systemic circulation were less than 7% over the course of the perfusion. CONCLUSION: In a porcine model, the PILP system can be safely and accurately positioned, and showed successful vascular isolation of the liver, with a leak rate to the systemic circulation of less than 7%.