Hepatic Arteriovenous Fistula After Percutaneous Liver Biopsy

Preger, Leslie

doi:10.2214/ajr.101.3.619

Cited by 67 publications

(14 citation statements)

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“…APFs have been said to result from congenital arteriovenous malformation, ruptured hepatic aneurysm, trauma, iatrogenic causes, liver cirrhosis, or liver tumor. Preger [3] first described an APF occurring after liver biopsy in 1967.…”

Section: Discussionmentioning

confidence: 99%

Gastric variceal bleeding caused by an intrahepatic arterioportal fistula that formed after liver biopsy: a case report and review of the literature

Iwaki

Matsuda

Yoshida

et al. 2012

Clin J Gastroenterol

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An intrahepatic arterioportal fistula is a rare cause of portal hypertension and variceal bleeding. We report on a patient with an intrahepatic arterioportal fistula following liver biopsy who was successfully treated by hepatectomy after unsuccessful arterial embolization. We also review the literature on symptomatic intrahepatic arterioportal fistulas after liver biopsy. A 48-year-old male with bleeding gastric varices and hepatitis B virus-associated liver cirrhosis was transferred to our hospital; this patient previously underwent percutaneous liver biopsies 3 and 6 years ago. Abdominal examination revealed a bruit over the liver, tenderness in the right upper quadrant, and splenomegaly. Ultrasonographic examination, computed tomography, and angiography confirmed an arterioportal fistula between the right hepatic artery and the right portal vein with portal hypertension. After admission, the patient suffered a large hematemesis and developed shock. He was treated with emergency transarterial embolization using microcoils. Since some collateral vessels bypassed the obstructive coils and still fed the fistulous area, embolization was performed again. Despite the second embolization, the collateral vessels could not be completely controlled. Radical treatment involving resection of his right hepatic lobe was performed. For nearly 6 years postoperatively, this patient has had no further episodes of variceal bleeding.

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Section: Discussionmentioning

confidence: 99%

Gastric variceal bleeding caused by an intrahepatic arterioportal fistula that formed after liver biopsy: a case report and review of the literature

Iwaki

Matsuda

Yoshida

et al. 2012

Clin J Gastroenterol

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“…The development of a significant arterioportal fistula may remain quiescent for a considerable time [12]. One patient developed hemobilia one week after biopsy [10] while another patient developed a continuous murmur over the liver within 24 h of biopsy [8]. The timing of the murmur in our case is not possible because it was not listened for prior to the angiogram.…”

Section: Discussionmentioning

confidence: 99%

“…A case of hepatic artery portal fistula, presenting with bleeding esophageal varices five months following a liver biopsy for cirrhosis, is presented. The angiographic features of the lesion are illustrated and the pertinent literature concerning etiology of hepatic arterioportal shunts is reviewed.Key words: Biopsy, complication -Liver, arteriovenous fistula -Liver, cirrhosis.Hepatic arterioportal shunts have been described in: severe cirrhosis [1,2] Although percutaneous liver biopsies have been performed for the past 20 years, the first documentation of arterioportal fistula complicating this procedure was not reported until 1967 [8, 13,14]. This reflects the delay in the development of angiographic technology to document such a complication as well as the lack of attentiveness to the physical sign of a continuous bruit over the liver.…”

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confidence: 99%

Hepatic arterioportal fistula related to a liver biopsy

Baer

1977

Gastrointest Radiol

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“…Patients with liver cirrhosis are particularly vulnerable to APF development due to a large number of performed biopsies [3–6]. …”

Section: Introductionmentioning

confidence: 99%

Zastosowanie okludera naczyniowego Amplatzer do zamknięcia tętnicy wątrobowej jako metoda leczenia szybkoprzepływowej przetoki tętniczo-wrotnej przed przeszczepem wątroby.

Poncyljusz

Pauli²

2012

Pol J Radiol

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SummaryBackground:Arterioportal fistula (APF) is an abnormal, direct connection between hepatic artery or its branch and the portal vein. Fistula can be acquired or, rarely, congenital. One of the acquired causes of fistula is a liver biopsy. Patients with liver cirrhosis are particularly vulnerable to its development due to the large number of performed biopsies. APF increases mortality and morbidity of liver transplantation procedure and may be a contraindication to it. The authors present a patient with liver cirrhosis, in whom percutaneous APF closure facilitated liver transplantation.Case Report:We describe a case of a 50-year-old patient with liver cirrhosis and APF, probably formed as a result of liver biopsy. Due to the presence of a high-flow fistula, which elevated portal hypertension, patient did not qualify for the liver transplantation. Patient was transferred to the interventional radiology department, where the fistula’s vascular supply was endovascularly closed using the Amplatzer occluder. This subsequently enabled the execution of transplantation.Conclusions:Percutaneous closure of APF should be considered a relatively simple and fast-acting tool to facilitate or even enable liver transplant surgery. Currently, there are more and more products available such as e.g. Amplatzer occluder to simplify the procedure and shorten the duration of exposure to ionizing radiation.

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Hepatic Arteriovenous Fistula After Percutaneous Liver Biopsy

Cited by 67 publications

References 1 publication

Gastric variceal bleeding caused by an intrahepatic arterioportal fistula that formed after liver biopsy: a case report and review of the literature

Gastric variceal bleeding caused by an intrahepatic arterioportal fistula that formed after liver biopsy: a case report and review of the literature

Hepatic arterioportal fistula related to a liver biopsy

Zastosowanie okludera naczyniowego Amplatzer do zamknięcia tętnicy wątrobowej jako metoda leczenia szybkoprzepływowej przetoki tętniczo-wrotnej przed przeszczepem wątroby.

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