THE ROLE OF ENDOVASCULAR INTERVENTION IN THE TREATMENT OF INTRAHEPATIC PORTOSYSTEMIC VENOUS SHUNT: A CASE REPORT
Main Article Content
Abstract
Intrahepatic Portosystemic Venous Shunt (IPSVS) is a rare vascular anomaly defined as an abnormal communication between the intrahepatic portal vein and the systemic venous system or hepatic veins. Although often asymptomatic and discovered incidentally, IPSVS can lead to serious complications such as hepatic encephalopathy. Endovascular embolization has been demonstrated to be an effective and minimally invasive treatment option. We report a case of a 77-year-old female diagnosed with IPSVS who was successfully treated with transhepatic embolization using a vascular plug. This case highlights the crucial role of diagnostic imaging in identifying and classifying the shunt, as well as the effectiveness of embolization in improving the patient’s condition.
Keywords
Intrahepatic portosystemic venous shunt, Amplatzer vascular plug, Endovascular intervention
Article Details
References
embolization using the Amplatzer Vascular Plug II. Korean J Radiol. 2012;13(6):827–31.
2. Remer EM, Motta-Ramirez GA, Henderson JM. Imaging findings in incidental intrahepatic portal venous shunts.
AJR Am J Roentgenol. 2007 Feb;188(2):W162-167.
3. Prabhakar N, Vyas S, Taneja S, Khandelwal N. Intrahepatic aneurysmal portohepatic venous shunt: what should
be done? Ann Hepatol. 2015;14(1):118–20.
4. Tanoue S, Kiyosue H, Komatsu E, Hori Y, Maeda T, Mori H. Symptomatic intrahepatic portosystemic venous shunt: embolization with an alternative approach. AJR Am J Roentgenol. 2003 Jul;181(1):71–8.
5. Park JH, Cha SH, Han JK, Han MC. Intrahepatic portosystemic venous shunt. AJR Am J Roentgenol. 1990 Sep;155(3):527–8.
6. Oguz B, Akata D, Balkanci F, Akhan O. Intrahepatic portosystemic venous shunt: diagnosis by colour/power
Doppler imaging and three-dimensional ultrasound. Br J Radiol. 2003 Jul;76(907):487–90.
7. Mori H, Hayashi K, Fukuda T, Matsunaga N, Futagawa S, Nagasaki M, et al. Intrahepatic portosystemic venous
shunt: occurrence in patients with and without liver cirrhosis. AJR Am J Roentgenol. 1987 Oct;149(4):711–4.
8. Kudo M, Tomita S, Tochio H, Minowa K, Todo A. Intrahepatic portosystemic venous shunt: diagnosis by color
Doppler imaging. Am J Gastroenterol. 1993 May;88(5):723–9.
9. Lane MJ, Jeffrey RB, Katz DS. Spontaneous intrahepatic vascular shunts. AJR Am J Roentgenol. 2000 Jan;174(1):125–31.
10. Hiraoka A, Kurose K, Hamada M, Azemoto N, Tokumoto Y, Hirooka M, et al. Hepatic encephalopathy due to
intrahepatic portosystemic venous shunt successfully treated by interventional radiology. Intern Med Tokyo Jpn.
2005 Mar;44(3):212–6.
11. Boixadera H, Tomasello A, Quiroga S, Cordoba J, Perez M, Segarra A. Successful embolization of a spontaneous
mesocaval shunt using the Amplatzer Vascular Plug II. Cardiovasc Intervent Radiol. 2010 Oct;33(5):1044–8.
12. Zhu X, Tam MDBS, Pierce G, McLennan G, Sands MJ, Lieber MS, et al. Utility of the Amplatzer Vascular Plug in
splenic artery embolization: a comparison study with conventional coil technique. Cardiovasc Intervent Radiol.
2011 Jun;34(3):522–31.
13. Ringe KI, Weidemann J, Rosenthal H, Keberle M, Chavan A, Baus S, et al. Transhepatic preoperative portal
vein embolization using the Amplatzer Vascular Plug: report of four cases. Cardiovasc Intervent Radiol. 2007;30(6):1245–7.
14. Lopera JE. The Amplatzer Vascular Plug: Review of Evolution and Current Applications. Semin Interv Radiol. 2015
Dec;32(4):356–69.
15. Yoo H, Ko GY, Gwon DI, Kim JH, Yoon HK, Sung KB, et al. Preoperative portal vein embolization using an amplatzer vascular plug. Eur Radiol. 2009 May 1;19(5):1054–61.