Canine and feline abdominal arterioportal communications can be classified based on branching patterns in computed tomographic angiography

Abstract

Arterioportal vascular anomalies are communications between the splanchnic arteries and the portal system that represent a rare cause of presinusoidal portal hypertension in small animals.There is little information concerning the imaging findings of arterioportal communications in small animals and no classification could be found for radiologists and surgeons. The aims of this retrospective descriptive multicentric study were to describe the computed tomographic characteristics of arterioportal communications in a group of cats and dogs, and to propose a classification based on computed tomography (CT) angiographic anatomy. Computed tomography databases from multiple veterinary hospitals were searched for cats and dogs with a diagnosis of arterioportal communication. A total of 36 animals (33 dogs, three cats) met the inclusion criteria. There were 32 intrahepatic arterioportal malformations and four extrahepatic fistulae. The intrahepatic arterioportal malformations were classified as right divisional (11/32) and left divisional (21/32), and the left divisional were subclassified as left medial (16/21) and left lateral (4/21). One patient showed multiple intrahepatic arterioportal communications with concomitant left medial and left lateral conformations. Two patients with intrahepatic arteriovenous malformation showed concomitant congenital intrahepatic shunts. The proposed anatomical classification based on CT angiography could allow veterinary radiologists to have a more systematic approach and help improve the radiologist-surgeon communication.

Diagnostic imaging for the assessment of acquired abdominal vascular diseases in small animals: A pictorial review

“…Acquired arterio‐venous fistulae have been reported in limbs of cats and dogs, but descriptions of such fistulae in the abdomen are lacking in small animals (Figure ) . Computed tomographic findings of arterio‐venous fistulae include filling with contrast medium of the efferent vein during the arterial phase, aneurysmatic dilation of the efferent vein due to chronic increased blood pressure, and turbulent blood flow related to arterialization …”

“…The imaging features of abdominal congenital vascular malformations, such as congenital portosystemic shunts, arterioportal malformations, azygos continuation of the caudal vena cava with and without concomitant portosystemic shunt, retrocaval ureter, caudal vena cava duplication, and caudal vena cava and portal vein aplasia, have been well described . In addition, MDCT anatomical criteria have been established for the diagnosis and classification of arterio‐portal malformation and a systematic “step‐by‐step” approach has been proposed for the ultrasonographic diagnosis of portosystemic shunts …”

“…[1][2][3][4][5] Multi-detector CT-angiography allows separate evaluation of the arterial, portal, and systemic venous circulations of the abdominal cavity, and the shape and distribution of the bolus of contrast media provides information on the dynamic of the blood flow during each phase. 6 Multi-detector CT-angiography and Doppler ultrasound offer powerful synergism when used in combination for the diagnosis, monitoring, and guidance of interventional procedures in patients with abdominal vascular diseases.…”

“…In addition, MDCT anatomical criteria have been established for the diagnosis and classification of arterio-portal malformation and a systematic "step-by-step" approach has been proposed for the ultrasonographic diagnosis of portosystemic shunts. 6,25 On the other hand, acquired vascular diseases remain largely unclassified and the value of diagnostic imaging for their identification and characterization has not been described in the veterinary literature. Yet, there is a growing interest in interventional radiology and veterinary radiologists are asked to assist, guide, and perform procedures that require a better understanding of the diagnostic approach, prognosis, and treatment options for acquired vascular diseases.…”

Evaluation of a pre‐tied ligature loop for canine total lung lobectomy

“…After completion of the cadaver study, PLL was successfully employed for total lung lobectomy in 5 dogs (Table 2) with median body weight of 17 kg (range [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Signalment, surgical approach, lung lobe resected, results of leak test, histopathological diagnosis, complications, and followup findings are presented in Table 2.…”