Simultaneous Portal and Hepatic Vein Versus Portal Vein Embolizations for Hypertrophy of the Future Liver Remnant

Inclusion Criteria:

• Liver metastases from colo-rectal origin considered as resectable (as validated by a multidisciplinary committee with at least one senior hepatic surgeon) provided sufficient FRL volume

• Percentage of FRL volume < 30%

• Age ≥ 18 years

• General health status World Health Organisation 0,1

• Estimated life expectancy > 3 months

• Patients whose biological parameters are :

• Platelets ≥100,000/mm3,

• Polynuclear neutrophils ≥ 1000/mm3,

• Hemoglobin≥ 9g/dL (even transfused patients can be included)

• Creatininemia < 1.5 times the normal value

• Creatinine clearance > 30 milliliters (mL)/min

• Bilirubinemia ≤ 1,5 times the normal value

• liver transaminases ≤ 5 times the normal value

• prothrombin rate > 70%

• Reference liver CT-Scan or MRI done during the 30 days preceding PVE or LVD.

• Written informed consent

• National health insurance cover

Exclusion criteria

• Patient with cirrhosis

• Presence of clinical ascites

• Ongoing participation or participation within the 21 days prior to inclusion in the study in another therapeutic trial with an experimental drug

• Serious non-stabilized disease, active uncontrolled infection or other serious underlying disorder likely to prevent the patient from receiving the treatment

• Pregnancy (betaHCG positive), breast-feeding or the absence of effective contraception for women of child-bearing age

• Contraindication for the MRI : Pacemaker or neurosensorial stimulator or implantable defibrillator, cochlear implant, ferromagnetic foreign body similar to the nervous structure.

• Allergy or contra-indication to iodine contrast agents (thyrotoxicosis, allergy to the active substance or excipients)

• Treatment with anticoagulants (heparin or AVK) that cannot be interrupted for 48 hours

• Treatment with anti-platelets that cannot be interrupted for 5 days for aspirin or Plavix

• Legal incapacity (persons in custody or under guardianship)

• Deprived of liberty Subject (by judicial or administrative decision)

• Impossibility to sign the informed consent document or to adhere to the medical follow-up of the trial for geographical, social or psychological reasons