Preparatory Angiogram (Mapping) for Radioembolization (SirSpheres)

Radioembolization is used to treat primary liver cancer and other cancers that have metastasized to the liver. The preparatory angiogram is performed to map out the veins and arteries of the liver and block those that leave the liver and go to other organs. This is done to prevent radioactive resin from traveling to other organs when the treatment dose is given (at your next visit).

Using x-ray guidance, a small catheter is inserted into an artery, usually in the upper thigh region, and fed up to the liver. A special dye is first injected which allows pictures to be taken and the vessels surrounding the tumor to be visualized. Platinum coils are then placed in certain vessels the doctor feels are necessary.

Diet
There are no dietary restrictions specifically due to this procedure. If you had restrictions prior due to other treatments or diseases such as diabetes, cardiovascular disease, or renal disease, continue with these.

Drink 6 to 8 glasses of liquid each day. Or, follow your caregiver’s advice if you must limit the amount of liquids you drink. Good liquids to drink are water, juices, and milk.

Medications

• You may restart your usual medications unless you have been told otherwise.
• Start taking Protonix 40 mg daily.
• If taking Glucophage (Metformin), this must be held for 2 days following this procedure.

Site Care

• Leave the dressing on for 24 hours, then you may remove and shower.
• Do not put any medicines on the wound.
• Replace band-aid until the wound is closed, usually 24-48 hours.
• Do not soak wound (tub bath, swimming, Jacuzzi) until the wound is completely healed (around 5 days).

Activity

• You may drive yourself in 24 hours.
• No heavy lifting/moving, exercise, sports, stair climbing, or sex until the wound is completely healed.
• Avoid “L” shape sitting until the wound is healed.
• Avoid tight-fitting clothes until the wound is healed.

EXPECTED SIDE EFFECTS

• You may have side effects from the medications used during the procedure to keep you comfortable. Many describe this feeling as a slight “hang-over”. Nausea may occur due to these medications but usually does not last longer than 12-24 hours.
• Aside from this and soreness at the catheter insertion site, you should not have many side effects.

Special Precautions
There are no special precautions following the preparatory angiogram. You do not need to use radiation safety precautions until after the treatment procedure (part 2).

Follow-up

• If you are not already scheduled for your treatment procedure, you will be called shortly after this procedure to discuss open dates. Please call us if you have not heard from us within 1 week.
• You may again need labs prior to the treatment procedure.

When to Get Medical and Emergency Help

• If you have a temperature over 101.0°F
• If you have new pain or symptoms you are concerned about
• Your nausea is so severe you cannot keep down any food or fluids
• You have questions about your treatment or new prescriptions
• You have pain where the catheter was placed that is worsening more than improving

Go to your nearest Emergency Room

• Your catheter site starts bleeding and will not stop after 10 minutes of firm pressure
• You have shaking chills or a temperature over 102°F