BackTable Vascular & Interventional Ep. 16 Pressure-Directed Therapy in Y90 with Dr. Nutting and Dr. Parikh
Nov 5, 2017
Dr. Charles Nutting, an interventional radiologist in Denver specializing in interventional oncology, joins Dr. Nainesh Parikh to delve into pressure-directed therapy in Y90 radioembolization. They discuss the advantages of pressure-directed devices over traditional methods for treating unresectable hepatocellular carcinoma. Highlights include insights on planning and mapping for treatment, the risks of non-target embolization, and real-world data implications. Practical tips for utilizing these innovative devices also spark interest among practitioners.
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Why Arterial Delivery Targets HCC
- HCC tumors receive most blood supply from the hepatic artery, so arterial delivery targets tumors preferentially.
- Radioembolization aims to deliver a full calculated radioactive dose into the arterial supply for effective treatment.
Stasis Can Reduce Delivered Dose
- Stasis during infusion can prevent delivering the full intended dose, potentially reducing efficacy.
- Pressure-directed devices can allow delivery of closer to 100% of the planned dose by avoiding premature stasis.
Non‑Target Embolization Harms Outcomes
- Non-target embolization increases adverse events like nausea and abnormal liver tests.
- Reducing inadvertent embolization likely improves patient outcomes and tolerability.