Enhancing liver regeneration prior to resection: A review of embolic materials utilized in portal vein embolization

Portal vein embolization (PVE) plays a pivotal role in the management of liver tumors, as it selectively interrupts the portal vein's branches to stimulate the expansion of the Future Liver Remnant (FLR), consequently mitigating the risks of postoperative hepatic insufficiency and hepatic failure. This analysis meticulously examines the properties, clinical applications, and their influence on FLR growth for a spectrum of embolic agents, including n-butyl cyanoacrylate (NBCA) glue, polyvinyl alcohol (PVA) particles, ethanol, gelatin sponge, ethiodized oil, fibrin sealant, central vascular plugs and coils, and sclerosants. Moreover, the review delves into the safety profile of PVE embolic materials, underscoring that while PVE is generally deemed secure, there is a necessity to remain cautious about potential adverse events, such as unintended embolization and post-embolization syndrome. The horizon for future research is set to encompass the innovation of novel embolic agents, the synergy of PVE with additional therapeutic approaches, and the resolution of challenges inherent in PVE studies. Ultimately, this review serves as a scientific reference for medical practitioners in their quest to identify the most suitable embolic materials for PVE, while underscoring the paramountcy of ongoing research in bolstering the procedure's safety and efficacy. This review assesses various embolic materials used in Portal Vein Embolization (PVE) for liver tumor management, evaluating their safety, efficacy, and impact on future liver remnant growth, while highlighting the need for caution regarding potential adverse events and the importance of ongoing research for improving PVE procedures.