PVE Update 9-19-23

Arrived at 8:30 am for a blood draw, checked in for PVE (portal vein embolization) at 10:15 and they wheeled him back shortly after 12:15.

Before the PVE took place they did a CT scan to review the left liver volume from the resection 2 weeks ago. The volume was a little lower than the original scan so both the interventional radiologist and his liver surgeon thought that adding a hepatic vein embolization would be in his best interest to give his left liver lobe the best chance at getting bigger.

The portal vein brings blood in from the colon (which is why live metastasis is so common with colon cancer). The hepatic vein flows blood from the liver to the inferior vena cava (heart). There are 3 hepatic veins (right, middle, left) and 2 portal veins (right and left).

They embolized the right portal vein with particles to block the blood flow to the right to push more blood to the left.

Then they embolized the right hepatic vein with surgical glue. The challenge with the hepatic veins is that there are small microvessels that can lead back from the right vein into the left or middle vein which then leads to the heart.

When they added the glue they could see a small amount of it travel into one of those small undetectable microvessles. When that happens they stop adding the glue because it would be really bad if more glue kept traveling. All that to say he has a partial blockage in the right hepatic vein and a full blockage in the right portal vein.

The whole procedure took 4.5 hours, which is why we will be spending another night here in Houston along with keeping his pain under control as they had to use two punctures instead of 1. Discharge looks hopeful for tomorrow (9/20) and we fly home on Thursday (9/21). We miss Silas like crazy and look forward to being under 1 roof again.

If you haven't ever read the book of Philippians due yourself a favor and read the first chapter - check it out here: https://www.biblegateway.com/passage/?search=Philippians%201&version=NIV

Verse 30 says "We are in this struggle together. You have seen my struggle in the past, and you know that I am still in the midst of it."

Even in the midst of our struggles we have clung to The Word of God and chosen Joy. Choosing joy doesn't mean that we don't have sadness, but it means we don't fixate on fear, worry, or anxiety. We choose Joy because of what we know we are promised.

We continue to pray for Zach's healing, peace, and joy in our lives and for those around us.

- Amber