TY - JOUR
T1 - Transsplenic Portal System Catheterization
T2 - Review of Current Indications and Techniques
AU - Zurcher, Kenneth S.
AU - Smith, Mathew V.
AU - Naidu, Sailendra G.
AU - Saini, Gia
AU - Patel, Indravadan J.
AU - Knuttinen, M. Grace
AU - Kriegshauser, J. Scott
AU - Oklu, Rahmi
AU - Alzubaidi, Sadeer J.
N1 - Publisher Copyright:
© RSNA, 2022.
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Multiple diseases of the portal system require effective portal vein access for endovascular management. While percutaneous trans-hepatic and transjugular approaches remain the standard methods of portal vein access, transsplenic access (TSA) has gained recognition as an effective and safe technique to access the portal system in patients with contraindications to traditional approach-es. Recently, the utility of percutaneous TSA has grown, with described treatments including recanalization of chronic portal vein occlusion, placement of stents for portal vein stenosis, portal vein embolization of the liver, embolization of gastric varices, placement of complicated transjugular intrahepatic portosystemic shunts, and interventions after liver transplant. The authors pro-vide a review of percutaneous TSA, including indications, a summary of related portal vein diseases, and the different techniques used for access and closure. In addition, an imaging-based review of technical considerations of TSA interventions is presented, with a review of potential procedural complications. With technical success rates that mirror or rival the standard methods and reported low rates of major complications, TSA can be a safe and effective option in clinical scenarios where traditional approaches are not feasible.
AB - Multiple diseases of the portal system require effective portal vein access for endovascular management. While percutaneous trans-hepatic and transjugular approaches remain the standard methods of portal vein access, transsplenic access (TSA) has gained recognition as an effective and safe technique to access the portal system in patients with contraindications to traditional approach-es. Recently, the utility of percutaneous TSA has grown, with described treatments including recanalization of chronic portal vein occlusion, placement of stents for portal vein stenosis, portal vein embolization of the liver, embolization of gastric varices, placement of complicated transjugular intrahepatic portosystemic shunts, and interventions after liver transplant. The authors pro-vide a review of percutaneous TSA, including indications, a summary of related portal vein diseases, and the different techniques used for access and closure. In addition, an imaging-based review of technical considerations of TSA interventions is presented, with a review of potential procedural complications. With technical success rates that mirror or rival the standard methods and reported low rates of major complications, TSA can be a safe and effective option in clinical scenarios where traditional approaches are not feasible.
UR - http://www.scopus.com/inward/record.url?scp=85137137278&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85137137278&partnerID=8YFLogxK
U2 - 10.1148/rg.220042
DO - 10.1148/rg.220042
M3 - Article
C2 - 35984753
AN - SCOPUS:85137137278
SN - 0271-5333
VL - 42
SP - 1562
EP - 1576
JO - Radiographics
JF - Radiographics
IS - 5
ER -