Veterinary Teaching Hospital, Washington State University, 255 East Main Street Pullman, Washington 99163, USA (Tiffinger, Fransson); Radia Inc., PS. 19020 33rd Avenue West, Lynnwood, Washington 98036, USA (Smith).
Can Vet J. 2024 Aug;65(8):763-768.
A 5-month-old Pembroke Welsh corgi dog was presented with a 3-month history of lethargy, inappetence, polyuria/polydipsia, and neurological signs. A diagnosis of a complex multiple intrahepatic portosystemic shunt (IHPSS) configuration was obtained by computed tomography angiogram, abdominal ultrasonography, and perioperative fluoroscopic angiography. The IHPSS was successfully attenuated by shunt embolization with a vascular plug, using a direct percutaneous hepatic approach under ultrasonographic and fluoroscopic guidance. Long-term (4 y) follow-up revealed resolution of all clinical signs. The owner elected to continue dietary modification and lactulose treatment indefinitely and the outcome was considered good. Key clinical message: Direct percutaneous hepatic approach could be considered for IHPSS attenuation in select cases where traditional transvenous approach access is considered challenging.
一只 5 月龄的彭布罗克威尔士柯基犬出现了 3 个月的昏睡、食欲不振、多尿/多饮和神经症状。通过计算机断层血管造影、腹部超声和围手术期荧光血管造影诊断为复杂的多发性肝内门体分流（IHPSS）。在超声和荧光引导下直接经皮肝途径，使用血管塞成功栓塞分流，从而减轻 IHPSS。长期（4 年）随访显示所有临床症状均已消退。主人选择继续进行饮食调整和乳果糖治疗，并无限期使用，结果被认为是良好的。主要临床信息：对于传统经静脉入路被认为具有挑战性的病例，可以考虑直接经皮肝途径来减轻 IHPSS。
