Before a planned extended right hepatectomy for a large liver tumour, the future liver remnant volume is judged insufficient. Which interventional radiology procedure is performed to induce compensatory hypertrophy of the future remnant?

• A Portal vein embolization of the segments to be resected ✓
• B Transarterial chemoembolization of the whole liver
• C Transjugular intrahepatic portosystemic shunt creation
• D Hepatic artery coil embolization of the right lobe

Explanation

Portal vein embolization occludes the portal branches supplying the segments scheduled for resection, usually via an ipsilateral transhepatic approach. Diverting portal flow to the remaining liver induces hypertrophy of the future remnant over several weeks, reducing the risk of post-hepatectomy liver failure. Embolizing the hepatic artery would cause tumour and parenchymal necrosis without driving remnant hypertrophy, and TIPS reduces portal perfusion rather than redirecting it selectively.

Reference: Grainger and Allison's Diagnostic Radiology, 7th ed.

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