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Radioemboliation or Y90

Radioembolization or Y90 is a minimally invasive procedure thats consists of both embolization and radiation therapy to treat inoperable liver cancer and liver metastases. Although Y90 is not curative, it can shrink tumors, improve quality of life and potentially extend survival for people with liver cancer.

Here at Houston Vein and Vascular, we offer this procedure to the patients seeking a minimally invasive options for treatment of unresectable liver tumors.  

the patient at the doctor's appointment points to the model of the liver. the doctor talks

Reasons you may choose Y90

  • symptom relief

  • Shrink tumors and make you prepared for a liver resection, ablation, or transplant

  • Potentially extend survival rates

  • Slow the progression of tumors

 

What to Expect from the Procedure

After numbing your skin, the doctor will make a small skin nick in the groin or wrist. Then, using x-ray guidance, he will navigate a small tube or catheter to the liver arteries. After the tube is properly placed, tiny radioactive beads will be deposited into the hepatic artery. You will be in recovery 1-2 hours following the procedure. The Y90 procedure requires a mapping procedure (phase 1) prior to treatment procedures targeting each half of the liver (Phase 2, and Phase 3).

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Recovery

Radioembolization is performed as an outpatient procedure and typically lasts 30-90 minutes. After your Y90 procedure you will rest in a recovery area for 1-2 hours before you are sent home. 

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You can expect to return to normal activities after leaving the clinic. However, most patients will experience fatigue for 1-4 weeks following the treatments. Other expected symptoms during this period include fever, nausea, vomiting, loss of appetite, and abdominal pain. If any of these side effects last more than 7 days, reach out to your doctor right away.

Due to the radioactive nature of the treatment the following precautions are recommended for three days after your treatment procedures (Phase 2, and 3):

  • Maintain a 6-ft distance from other adults if contact will last for more than a few minutes

Take the following precautions for one week after your procedure:

  • Do not use public transportation that will require you to sit next to another person for >2 hours

  • Do not sleep in the same bed as your partner

  • Avoid close contact with pregnant women and children

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Chemoembolization 

During chemoembolization, chemotherapy drugs are injected directly into the blood vessel feeding a cancerous tumor. In order to augment the effects of the chemotherapy agent within the tumor, an embolic material is also placed inside the blood vessel supplying the tumor. This procedure can also be performed without the use of chemotherapy agents (embolization) with similar results. 

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Am I a Candidate for Embolization?

Prior to Embolization or chemoembolization, your vascular and interventional radiologist will further evaluate you and may recommend that you have several tests, including liver function blood tests, and a CT scan or an MRI of your liver. 

These tests are used to rule out the following:

  • Portal vein blockage

  • Bile duct Blockage

Embolization only treats tumors in the liver without any effect on any other cancer in the body. The following are liver cancers that can be treated:

  • Hepatocellular Carcinoma or HCC (primary liver cancer)

  • Large symptomatic hemangiomas 

  • Metastatic to the liver from these primary cancers

    • Colon cancer

    • Carcinoid

    • Ocular melanoma

    • Sarcomas

    • Primary tumor in another part of the body

Percutaneous Ablation of Tumor

Ablation uses high energy to freeze or heat the tumor and destroy the cancer cells. This technique is commonly used in patients with a few small tumors and when surgery is not a good option. It is most commonly used to treat tumors in the liver, kidneys, and lungs.

Ablation can be an adjunct to others treatments such as surgery, radiation therapy, chemotherapy, hepatic arterial infusion therapy, alcohol ablation, y90 or chemoembolization. 

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Ablation is often an effective treatment option if you meet the following criteria:

  • Not a good surgical candidate because your tumor is difficult to reach

  • Multiple small liver tumors that are too spread out to be removed surgically

  • liver tumors not responsive to chemotherapy or have recurred after surgical resection

  • After undergoing surgical removal of a tumor, would not have enough liver tissue left for the organ to function

  • Have medical problems making surgery highly risky

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What to Expect from the Procedure

Ablation is an outpatient procedure with each ablation taking about 10-30 minutes. The entire procedure is usually completed within 1-2 hours. Using imaging-guidance, your vascular and interventional radiologist will insert the needle electrode through the skin and advance it to the site of the tumor. Depending on the size of the tumor, it may be necessary to do multiple ablations by repositioning the needle electrode or by placing multiple needles into different parts of the tumor to ensure comprehensive treatment.

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You will likely have follow up CT or MRI scans every three to four months to check for new tumors.

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