Radioembolization (Y-90)

What Is Y-90 Radioembolization?

Radioembolization is a minimally invasive procedure that combines embolization and radiation therapy to treat liver cancer. Tiny glass or resin beads filled with the radioactive isotope yttrium Y-90 are placed inside the blood vessels that feed a tumor. This blocks the supply of blood to the cancer cells and delivers a high dose of radiation to the tumor while sparing normal tissue. It can help extend the lives of patients with inoperable tumors and improve their quality of life.

Before The Procedure

Prior to your procedure, your blood may be tested to determine how well your kidneys are functioning and whether your blood clots normally. You also will have an angiogram that will produce pictures of the blood vessels feeding the tumor 7 to 10 days before your procedure. You will need to make plans for your return home following your procedure as your contact with children and adults may be restricted for 3 to 7 days.

You should report to your doctor all medications that you are taking, including herbal supplements, and if you have any allergies. Your doctor may advise you to stop taking certain medications.

You will be given a sedative during the procedure. You will receive specific instructions on eating and drinking before the procedure and will need to have a relative or friend accompany you and drive you home afterward.

During The Procedure

Devices to monitor your heart rate and blood pressure will be attached to your body. You will feel a slight pin prick when the needle is inserted into your vein for the intravenous line (IV) and when the local anesthetic is injected. Most of the sensation is at the skin incision site which is numbed using local anesthetic. If the procedure is done with sedation, the intravenous (IV) sedative will make you feel relaxed and sleepy. You may or may not remain awake, depending on how deeply you are sedated.

You may feel slight pressure when the catheter is inserted, but no serious discomfort. As the contrast material passes through your body, you may get a warm feeling. Radioembolization is generally painless; however, some patients may experience brief pain when the microspheres are injected. Your procedure can take anywhere from 1 to 3 hours.

After The Procedure

At the end of the procedure, the catheter will be removed, and pressure will be applied to stop any bleeding. The opening in the skin is then covered with a dressing. No sutures are needed. Your intravenous (IV) line will be removed. You will remain in the recovery area until you are completely awake and ready to return home.

Some patients experience some side effects called post-embolization syndrome, including nausea, vomiting and fever. Pain is the most common side effect that occurs because the blood supply to the treated area is cut off. It can readily be controlled by medications given by mouth or your IV. These side effects usually subside within 3 to 5 days and may be alleviated with medication. You should tell your doctor if these symptoms last more than 7 to 10 days. You also may experience a low-grade fever, lethargy and fatigue that usually last about 1 week.

You should be able to resume normal activities within a day or two following the procedure. During the week following your radioembolization, you will need to limit contact with others while the radiation in your body diminishes. You should not do the following for at least 7 days after the procedure:

• Sleep in the same bed as your partner.
• Use public transportation that requires you to sit next to another person for more than 2 hours.
• Come in close contact with children or pregnant women.

Your interventional radiologist may recommend a follow-up visit after your procedure or treatment is complete.