Percutaneous Transhepatic and Transsplenic Portal Vein Access: Embolization of the Puncture Tract Using Amplatzer Vascular Plugs

Dollinger, M. and Goessmann, H. and Mueller-Wille, R. and Wohlgemuth, W. A. and Stroszczynski, C. and Heiss, P. (2014) Percutaneous Transhepatic and Transsplenic Portal Vein Access: Embolization of the Puncture Tract Using Amplatzer Vascular Plugs. ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN, 186 (2). pp. 142-150. ISSN 1438-9029, 1438-9010

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Abstract

Purpose: To report on first results of the embolization of transhepatic and transsplenic puncture tracts using an Amplatzer Vascular Plug (AVP) after percutaneous portal vein intervention. Materials and Methods: Embolization of transhepatic and transsplenic puncture tracts with AVP was attempted in 5 patients (3 females; age range: 3-71 years). Portal vein access was gained by a transhepatic (n=4) or transsplenic (n=1) approach, and stenosis (n=2) or thrombosis (n=3) of the portal vein was successfully treated by percutaneous stenting or thrombus aspiration and thrombolysis using 6 to 10 French sheaths. Due to the relatively large bore and/or short transparenchymal puncture tracts, it was considered favorable to use AVPs as an embolic agent. The medical records, the radiological reports and images of these 5 patients were retrospectively evaluated. Result: In three cases one AVP II (diameter, 4mm), in one case one AVP IV (diameter, 4mm) and in one case two AVPs II (diameter, 8 and 6mm) were used for embolization of the puncture tract. In all five cases embolization was technically successful. There was no bleeding from the puncture tract. During a median follow-up of 14 months (range, 21 days to 21 months), one patient developed a focal liver abscess adjacent to the AVP which was successfully treated by antimicrobial and drainage therapy. There were no further embolization-related complications. Conclusion: AVPs are suited to embolize large bore and/or short transhepatic and transsplenic puncture tracts effectively, safely, and precisely. Caution is required in patients with an increased risk for infectious complications. Key Points: center dot Embolization of transhepatic and transsplenic puncture tracts with AVPs is feasible center dot Large and/or short puncture tracts can be effectively embolized with AVPs center dot The risk of infectious complications has to be considered Citation Format: center dot Dollinger M, Goessmann H, Mueller-Wille R etal. Percutaneous Transhepatic and Transsplenic Portal Vein Access: Embolization of the Puncture Tract Using Amplatzer Vascular Plugs. Fortschr Rontgenstr 2014; 186: 142-150

Item Type: Article
Uncontrolled Keywords: DONOR LIVER-TRANSPLANTATION; VENOUS STENOSIS; STENT PLACEMENT; COMPLICATIONS; MANAGEMENT; THROMBOSIS; SURGERY; BIOPSY; percutaneous transhepatic and transsplenic portal vein access; puncture tract embolization; Amplatzer Vascular Plug
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Röntgendiagnostik
Depositing User: Dr. Gernot Deinzer
Date Deposited: 28 Nov 2019 09:21
Last Modified: 28 Nov 2019 09:21
URI: https://pred.uni-regensburg.de/id/eprint/10747

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