Balloon Occlusion Technique During Y90 Radioembolization

The conventional technique for 90Y microsphere treatment planning involves diagnostic angiography with prophylactic embolization of hepatoenteric collaterals to prevent non-target microsphere administration. In some instances, embolization is not technically feasible due to anatomy or the size of the collateral vessel. In lieu of prophylactic embolization, the balloon occlusion technique may be employed. The technique uses a compliant balloon to temporarily occlude the common hepatic artery to induce reversal of arterial flow in various hepatoenteric collaterals (gastroduodenal, right gastric, supraduodenal, etc.). This technique is generally employed in patients with Michaels type 1 anatomy; however, it can also be used in patients with variant anatomy.