Saito Hidemasa, Murata Satoru, Sugihara Fumie, Ueda Tatsuo, Yasui Daisuke, Miki Izumi, Hayashi Hiromitsu, Kumita Shin-Ichiro
Department of Radiology, Nippon Medical School, Tokyo 113-8602, Japan.
Center for Interventional Radiology, Teikyo University Chiba Medical Center, Chiba 299-0011, Japan.
World J Clin Cases. 2022 Feb 26;10(6):2023-2029. doi: 10.12998/wjcc.v10.i6.2023.
A congenital intrahepatic portosystemic shunt (IPSVS) is a rare vascular abnormality that is characterized by an anomalous intrahepatic venous tract that connects the intrahepatic portal vein with the hepatic venous system. Hepatic encephalopathy is an indication for IPSVS embolization, which is technically challenging because rapid blood flow through shunts can induce the migration of embolization material to systemic veins. This case report discusses the efficacy of percutaneous balloon-occluded retrograde transvenous obliteration for treating patients with IPSVSs.
A 75-year-old woman presented with a six-month history of repeated hepatic encephalopathy due to an IPSVS without liver cirrhosis. We successfully embolized the IPSVS using percutaneous balloon-occluded retrograde transvenous obliteration with interlocking detachable coils. After the procedure, the patient exhibited no symptoms of hepatic encephalopathy for 14 mo.
Balloon-occluded retrograde transvenous obliteration with detachable coils can be effective for the endovascular treatment of an IPSVS.
先天性肝内门体分流(IPSVS)是一种罕见的血管异常,其特征是存在一条异常的肝内静脉通道,该通道将肝内门静脉与肝静脉系统相连。肝性脑病是IPSVS栓塞治疗的指征,由于通过分流的快速血流可导致栓塞材料迁移至体静脉,因此该技术具有挑战性。本病例报告讨论经皮球囊闭塞逆行静脉闭塞术治疗IPSVS患者的疗效。
一名75岁女性因无肝硬化的IPSVS出现反复肝性脑病6个月。我们使用带锁可脱卸线圈经皮球囊闭塞逆行静脉闭塞术成功栓塞了IPSVS。术后,患者14个月未出现肝性脑病症状。
带锁可脱卸线圈球囊闭塞逆行静脉闭塞术对IPSVS的血管内治疗可能有效。