TY - JOUR
T1 - Safety and effectiveness of transsplenic access for portal venous interventions
T2 - a single-center retrospective study
AU - Al-Ogaili, Mustafa
AU - Beizavi, Zahra
AU - Naidu, Sailendra G.
AU - Patel, Indravadan J.
AU - Knuttinen, Grace
AU - Wallace, Alex
AU - Oklu, Rahmi
AU - Klanderman, Molly C.
AU - Alzubaidi, Sadeer J.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
PY - 2024/8
Y1 - 2024/8
N2 - Purpose: To assess the safety and effectiveness of percutaneous transsplenic access (PTSA) for portal vein (PV) interventions among patients with PV disease. Materials and methods: Adult patients with PV disease were enrolled if they required percutaneous catheterization for PV angioplasty, embolization, thrombectomy, variceal embolization, or transjugular intrahepatic portosystemic shunt (TIPS) placement for a difficult TIPS or recanalization of a chronically occluded PV. The procedures were performed between January 2018 and January 2023. Patients were excluded if they had an active infection, had a chronically occluded splenic vein malignant infiltration of the needle tract, had undergone splenectomy, or were under age 18 years. Results: Thirty patients (15 women, 15 men) were enrolled. Catheterization of the PV through PTSA succeeded for 29 of 30 patients (96.7%). The main adverse effect recorded was flank pain in 5 of 30 cases (16.7%). No bleeding events from the spleen, splenic vein, or percutaneous access point were recorded. Two cases (6.7%) each of hepatic bleeding and rethrombosis of the PV were reported, and a change in hemoglobin levels (mean [SD], − 0.5 [1.4] g/dL) was documented in 14 cases (46.7%). Conclusion: PTSA as an approach to accessing the PV is secure and achievable, with minimal risk of complications. Minimal to no bleeding is possible by using tract closure methods.
AB - Purpose: To assess the safety and effectiveness of percutaneous transsplenic access (PTSA) for portal vein (PV) interventions among patients with PV disease. Materials and methods: Adult patients with PV disease were enrolled if they required percutaneous catheterization for PV angioplasty, embolization, thrombectomy, variceal embolization, or transjugular intrahepatic portosystemic shunt (TIPS) placement for a difficult TIPS or recanalization of a chronically occluded PV. The procedures were performed between January 2018 and January 2023. Patients were excluded if they had an active infection, had a chronically occluded splenic vein malignant infiltration of the needle tract, had undergone splenectomy, or were under age 18 years. Results: Thirty patients (15 women, 15 men) were enrolled. Catheterization of the PV through PTSA succeeded for 29 of 30 patients (96.7%). The main adverse effect recorded was flank pain in 5 of 30 cases (16.7%). No bleeding events from the spleen, splenic vein, or percutaneous access point were recorded. Two cases (6.7%) each of hepatic bleeding and rethrombosis of the PV were reported, and a change in hemoglobin levels (mean [SD], − 0.5 [1.4] g/dL) was documented in 14 cases (46.7%). Conclusion: PTSA as an approach to accessing the PV is secure and achievable, with minimal risk of complications. Minimal to no bleeding is possible by using tract closure methods.
KW - Angioplasty
KW - Embolization
KW - Portal
KW - Spleen
KW - Splenic vein
KW - TIPS
KW - Transhepatic
KW - Transmesenteric
KW - Transsplenic
KW - Varices
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U2 - 10.1007/s00261-024-04237-4
DO - 10.1007/s00261-024-04237-4
M3 - Article
C2 - 38748092
AN - SCOPUS:85193347357
SN - 2366-004X
VL - 49
SP - 2726
EP - 2736
JO - Abdominal Radiology
JF - Abdominal Radiology
IS - 8
ER -