Portal Vein Embolization (PVE) is an advanced medical procedure in the field of interventional radiology aimed at increasing the volume and function of the healthy liver remnant that will remain following a hepatic resection (Hepatectomy).
 

The procedure is essential for patients suffering from primary tumors such as Hepatocellular Carcinoma or Intra-hepatic Cholangiocarcinoma and liver metastases, which require surgical removal of a large portion of the organ, when the remaining tissue is not large enough to sustain life functions and prevent post-operative liver failure. The central concept is to utilize the liver's unique ability to regenerate by diverting blood flow and nutrients toward the healthy section, which triggers an accelerated growth process known as hypertrophy. Thanks to this technique, many patients previously considered unresectable become suitable candidates for life-saving surgery.

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The treatment process begins with a meticulous evaluation including advanced imaging tests such as CT or MRI for the precise calculation of the various liver volumes and the performance of volumetry. On the day of the procedure, the interventional radiologist inserts a thin catheter under ultrasound and X-ray fluoroscopy guidance into the portal venous system of the liver. Access is typically achieved through a small skin puncture, the physician navigates the catheter to the portal vein branches supplying the areas intended for resection and injects embolic agents including alcohol, embolic particles, glue and coils.
This blockage causes blood flow to be diverted to the healthy part, leading to its rapid growth within a period of four to six weeks; in some cases, liver venous deprivation (LVD) can also be performed to further accelerate the growth rate and achieve better results in a shorter timeframe.