Successful embolisation of intrahepatic portosystemic venous shunt using coils and n-butyl cyanoacrylate through two approach routes

Yoshimatsu, Rika; Takeuchi, Yoshito; Morishita, Hiroyuki; Iida, Noriko; Okabe, Hidetoshi; Yamagami, Takuji

doi:10.1259/bjr/10360703

Cited by 18 publications

(19 citation statements)

References 11 publications

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“…A type IV IPSVS is a tubular communication between the RPV and the inferior vena cava. 2 We classified our case as an aneurysmal form of Chevallier type II IPSVS, since the shunt between the RPV and the RHV was located in 2 adjacent liver segments. The etiology of our patient's shunt is most likely spontaneous, since there was no history of liver biopsy, hepatic surgery or trauma, cirrhosis, chronic hepatitis, hepatic malignancy, or any other liver disease.…”

Section: Discussionmentioning

confidence: 99%

“…5 Spontaneous IPSVS is a relatively rare entity. 2 A 2005 prospective study screened 25 579 adults without potential cause of IPSVS with B-mode and color Doppler sonography to assess the incidence and clinical significance of spontaneous IPSVS. 5 Of the 25 579 screened adults, only 6 (0.0235%) patients showed evidence of spontaneous IPSVS on color Doppler sonography.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Intrahepatic Portal Venous Shunt

Sheth

Sabbah

Contractor

2016

Vasc Endovascular Surg

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spontaneous Intrahepatic Portal Venous Shunt

Sheth

Sabbah

Contractor

2016

Vasc Endovascular Surg

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“…1 Angiographic interventions with coil embolization using stainless steel or platinum coil, or transcathetar embolization have been described in recent years. 2,3,4 Glue (n-butyl cyanoacrylate) is a liquid embolizing agent successfully used in few cases of IHPSVS. 3 In the index case, the patient had developed features of hepatic encephalopathy, Doppler and CT revealed IHPSVS type IV (Park), so the angiographic intervention was planned to arrest further progression of the disease or amelioration of the symptoms if possible.…”

Section: Discussionmentioning

confidence: 99%

“…2,3,4 Glue (n-butyl cyanoacrylate) is a liquid embolizing agent successfully used in few cases of IHPSVS. 3 In the index case, the patient had developed features of hepatic encephalopathy, Doppler and CT revealed IHPSVS type IV (Park), so the angiographic intervention was planned to arrest further progression of the disease or amelioration of the symptoms if possible. Selective injection of hepatic veins revealed two IHPSVS between right hepatic and portal vein communicating through multiple sinusoids.…”

Section: Discussionmentioning

confidence: 99%

Embolization of congenital intrahepatic porto-systemic shunt by n-butyl cyanoacrylate

et al. 2009

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Congenital intrahepatic portosystemic venous shunt (IHPSVS) is rare vascular anomaly. We present one case of a 14-month male child who presented with global developmental delay. Child had high ammonia levels with low glutamine and high bile salts on the previous investigations and had history of neonatal seizures since day 13 of life. On admission, serum ammonia levels were elevated to 112micromol/L. Other laboratory investigations including liver and renal function test, and electrolytes were normal. He was, diagnosed to have IHPSVS on the basis of Doppler and CT, and treated by embolization with n-butyl cyanoacrylate (glue). A brief review of diagnostic modalities and endovascular management for the IHPSVS is presented including the present case.

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“…Venogram showed rapid blood flow to the inferior vena cava. Metallic coil embolization is expensive and requires a large number of metallic coils 12 . However, since it was impossible to use a retrograde approach such as BRTO, we had to use coils to regulate the blood flow.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous transretroperitoneal direct approach to occlude a major shunt in a patient with extrahepatic portal–systemic encephalopathy

Murakami¹,

Nishino²,

Satou³

et al. 2009

Hepatology Research

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A 73-year-old woman had sudden dystrophy and amnesia in our hospital. Her serum ammonia level was high. Marked collateral vessels from the splenic vein to the left renal vein around the spleen were seen on a computed tomography (CT) scan with contrast enhancement. An abdominal angiogram showed that the direction of the splenic vein was hepatofugal on superior mesenteric arterial portography, with a marked splenorenal shunt on splenic arterial portography. Hepatic encephalopathy due to a marked extrahepatic portal-systemic shunt was diagnosed. Transjugular retrograde obliteration (TJO) was attempted, but the catheter and guide wire could not selectively approach the splenorenal shunt because of many outflow routes. We punctured the vessels from the left side of the back under ultrasonographic guidance. We injected microcoils and ethanolamine oleate to completely obliterate the shunt. Marked collateral vessels showed no venous flow on a CT scan after treatment. The serum ammonia level was in the normal range. There has been no recanalization of the shunt vessels for 4 years after treatment. Hepatic encephalopathy has not recurred, and no other collateral vessels have developed. To our knowledge, this is the first report to document the use of a percutaneous transretroperitoneal direct approach to occlude a major shunt in a patient with extrahepatic portal-systemic encephalopathy.

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Successful embolisation of intrahepatic portosystemic venous shunt using coils and n-butyl cyanoacrylate through two approach routes

Cited by 18 publications

References 11 publications

Spontaneous Intrahepatic Portal Venous Shunt

Spontaneous Intrahepatic Portal Venous Shunt

Embolization of congenital intrahepatic porto-systemic shunt by n-butyl cyanoacrylate

Percutaneous transretroperitoneal direct approach to occlude a major shunt in a patient with extrahepatic portal–systemic encephalopathy

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