| Literature DB >> 32655241 |
Karan M Anandpara1, Amar Mukund1, Shiv K Sarin2.
Abstract
Balloon- or plug-assisted retrograde transvenous obliteration of portosystemic shunts is an effective endovascular technique for the treatment of type B bypass hepatic encephalopathy. We describe a patient who underwent balloon- and plug-assisted obliteration for a lienorenal and lienogonadal shunt, respectively. He returned with symptoms of recurrent hepatic encephalopathy two years later due to reformation of new lienorenal and lienogonadal shunts. Repeat obliteration of these new shunts was now performed using balloon and coil assistance. We describe the treatment for multiple portosystemic shunts with combined usage of vascular plug, balloon and coils depending on anatomical and technically factors. Our case also highlights that after shunt obliteration increased portal pressure may form new portosystemic collateral pathways which leads to clinical failure and may require repeat treatment.Entities:
Keywords: BRTO, balloon-occluded retrograde transvenous obliteration; CFV, common femoral vein; CLD, chronic liver disease; CT, computed tomography; HE, hepatic encephalopathy; IJV, internal jugular vein; PARTO, plug-assisted retrograde transvenous obliteration; SPSS, spontaneous portosystemic shunts; balloon-occluded retrograde transvenous obliteration (BRTO); chronic liver disease (CLD); hepatic encephalopathy (HE); plug-assisted retrograde transvenous obliteration (PARTO); portal hypertension
Year: 2019 PMID： 32655241 PMCID： PMC7335714 DOI： 10.1016/j.jceh.2019.12.002
Source DB: PubMed Journal: J Clin Exp Hepatol ISSN： 0973-6883