Portal Vein Aneurysm Treated With Trans-Jugular Intrahepatic Porto-Systemic Shunt

Dunlap, Robert E.; Golden, Sean K.; Lyons, Gray R.

doi:10.1177/15385744211023291

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…The treatment may lead to other complications such as hepatic encephalopathy and liver failure 15 , 16 . Analysis of the reasons shows that a large amount of portal blood is directly shunted into the vena cava, causing ischemia and atrophy of the liver, inducing or aggravating the decline of liver function, resulting in liver function failure.…”

Section: Discussionmentioning

confidence: 99%

Risk factors analysis of endoscopy and TIPS in the treatment of secondary esophagogastric varicose bleeding with cirrhosis

Liu,

Wang,

Zheng

et al. 2023

Afr H. Sci.

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Objective: To analyse the risk factors of secondary hemorrhage and survival rate in cirrhotic patients with esophagogastric varicealrupture and to compare the efficacy and safety of endoscopic hemostasis and TIPS (transjugular intrahepatic portosystemicshunt). Methods: A total of 120 patients with secondary bleeding after endoscopic treatment of esophagogastric varicose bleeding withcirrhosis in our hospital during the past 3 years were retrospectively analysed. There were 65 males and 55 females, ranging inage from 49 to 74 years old, with an average of (59.5 ± 8.4) years old. The etiology, degree of varicose veins, bleeding location,hemostasis method, Infection, ascites, portal vein thrombosis or cancer thrombus, albumin, platelets, prothrombin activity, ChildPugh (Child-Pugh classification is a diagnostic criterion for liver reserve function) grade were compared in each group. The riskfactors of treatment failure and analyse the survival time was analysed. Results: There were statistically significant differences in varicosis degree, infection, ascites, portal vein thrombosis or cancerthrombus, child Pugh grade, albumin and prothrombin activity between the failed Endoscopy group and the successful hemostasisgroup (P< 0.05). There were statistically significant differences in child Pugh grade, albumin and prothrombin activity betweenthe failed TIPS treatment group and successful hemostasis group (P< 0.05). There was no significant difference in 1-yearsurvival between the endoscopy group and the TIPS group. Conclusion: Severe varicose veins, infection, ascites, portal vein thrombosis or cancer thrombus, child pugh classification, albumin,and prothrombin activity were the major risk factors for failed secondary endoscopic therapy, child Pugh classification,albumin and prothrombin activity were the main risk factors for failure TIPS treatment. There is no significant difference inlong-term survival between the two methods. Keywords: Liver cirrhosis; esophagogastric varicose bleeding; Endoscopy; TIPS.

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Section: Discussionmentioning

confidence: 99%

Risk factors analysis of endoscopy and TIPS in the treatment of secondary esophagogastric varicose bleeding with cirrhosis

Liu,

Wang,

Zheng

et al. 2023

Afr H. Sci.

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“…The patient remained asymptomatic for 72 mo[ 45 ]. Dunlap et al [ 46 ] also used a TIPS successfully to treat a PVA resulting from portal hypertension and liver cirrhosis. Kohlbrenner et al [ 47 ] demonstrated transhepatic pharmacomechanical thrombolysis of a large thrombosed PVA.…”

Section: Etiology Multimodal Imaging and Current Managementmentioning

confidence: 99%

Portal vein aneurysm-etiology, multimodal imaging and current management

Kurtcehajic¹,

Zerem²,

Alibegovic³

et al. 2023

World J Clin Cases

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Portal vein aneurysm (PVA) is a rare vascular abnormality, representing 3% of all venous aneurysms in the human body, and is not well understood. It can be congenital or acquired, located mainly at the level of confluence, main trunk, branches and bifurcation. A PVA as an abnormality of the portal venous system was first reported in 1956 by Barzilai and Kleckner. A review from 2015 entitled “Portal vein aneurysm: What to know” considered fewer than 200 cases. In the last seven years, there has been an increase in the number of PVAs diagnosed thanks to routine abdominal imaging. The aim of this review is to provide a comprehensive update of PVA, including aetiology, epidemiology, and clinical assessment, along with an evaluation of advanced multimodal imaging features of aneurysm and management approaches.

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Large thrombosed portomesenteric venous aneurysm treated with pharmacomechanical thrombolysis combined with TIPS placement

et al. 2022

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Background Aneurysms are rare anomalies of the portomesenteric venous system. Thrombotic complications of these lesions can lead to mesenteric venous ischemia and bowel infarction, potentially requiring surgical intervention. Herein we describe a case of mesenteric ischemia due to a large thrombosed portomesenteric aneurysm treated with endovascular techniques. Case presentation A 37-year-old previously healthy male who presented with abdominal pain to his local emergency department was found to have a thrombosed 12.0 × 5.1 cm portomesenteric venous aneurysm with evidence of mesenteric ischemia on CT. When conservative management with anticoagulation failed, transhepatic pharmacomechanical thrombolysis was initially performed. This was followed by TIPS placement with additional trans-TIPS thrombectomy to improve sluggish portal outflow and prevent re-thrombosis. The patient’s symptoms and imaging findings of ischemia resolved after endovascular therapy. No surgical intervention was required, and the patient was discharged on enoxaparin before being transitioned to apixaban. The TIPS remained patent at 2-year follow-up, with no change in the size of the aneurysm or re-thrombosis noted. The patient’s synthetic liver function was preserved with no evidence of hepatic encephalopathy during the follow-up period. Conclusions Endovascular therapies may be used to manage thrombotic complications of portomesenteric venous aneurysms, obviating the need for surgical intervention in selected patients.

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Portal Vein Aneurysm Treated With Trans-Jugular Intrahepatic Porto-Systemic Shunt

Cited by 3 publications

References 15 publications

Risk factors analysis of endoscopy and TIPS in the treatment of secondary esophagogastric varicose bleeding with cirrhosis

Risk factors analysis of endoscopy and TIPS in the treatment of secondary esophagogastric varicose bleeding with cirrhosis

Portal vein aneurysm-etiology, multimodal imaging and current management

Large thrombosed portomesenteric venous aneurysm treated with pharmacomechanical thrombolysis combined with TIPS placement

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