Surgeons can remove up to 80 percent of the liver and it will grow back in a matter of weeks provided the liver is healthy. Nonetheless, some patients do not have enough healthy liver tissue to enable an extensive resection. For these patients, an IR procedure called portal vein embolization (PVE) can make surgery possible by increasing the volume of healthy liver.
PVE is performed several weeks before the planned liver surgery. Using catheter-based tools, an interventional radiologist blocks the branch of the portal vein that supplies blood to the side of the liver planned for removal. This causes the other side of the liver to grow larger. In patients who do not have underlying liver disease, the healthy part of the liver will grow enough in several weeks to make surgery possible. Patients with less than 30 percent healthy liver usually undergo PVE before surgery to increase their remnant liver volume.