CardioVascular and Interventional Radiology

, Volume 33, Issue 5, pp 1044–1048 | Cite as

Successful Embolization of a Spontaneous Mesocaval Shunt Using the Amplatzer Vascular Plug II

  • Helena Boixadera
  • Alejandro Tomasello
  • Sergi Quiroga
  • Joan Cordoba
  • Mercedes Perez
  • Antoni Segarra
Case Report

Abstract

A 48-year-old man with alcoholic liver cirrhosis and hepatic encephalopathy was found to have a large, spontaneous mesocaval shunt. The shunt was successfully occluded with the use of an Amplatzer Vascular Plug. To our knowledge, this is the first report of the use of this device to embolize a mesocaval shunt involving the superior mesenteric vein.

Keywords

Hepatic encephalopathy Mesocaval shunt Amplatzer Vascular Plug Embolization Portosystemic shunt Portal hypertension 

Notes

Acknowledgments

The authors thank Nuria Albero for her support with the material and Cristina Losada and Fernando Muñoz for their help in figure acquisition.

References

  1. 1.
    Park SW, Kang HS, Kim YJ et al (2007) Successful occlusion of spontaneous portosystemic shunts leading to encephalopathy in a non-cirrhotic patient by using the Amplatzer vascular plug. Acta Radiol 48(10):1077–1081CrossRefPubMedGoogle Scholar
  2. 2.
    Ito K, Higuchi M, Kada T et al (1997) CT of acquired abnormalities of the portal venous system. RadioGraphics 17:897–917PubMedGoogle Scholar
  3. 3.
    Gallego C, Velasco M, Marcuello P et al (2002) Congenital and acquired anomalies of the portal venous system. RadioGraphics 22:141–159PubMedGoogle Scholar
  4. 4.
    Sakurabayashi S, Sezai S, Yamamoto Y et al (1997) Embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy. Cardiovasc Interv Radiol 20(2):120–124CrossRefGoogle Scholar
  5. 5.
    Kessler J, Trerotola SO (2006) Use of the Amplatzer Vascular Plug for embolization of a large retroperitoneal shunt during transjugular intrahepatic portosystemic shunt creation for gastric variceal bleeding. J Vasc Interv Radiol 17(1):135–140CrossRefPubMedGoogle Scholar
  6. 6.
    Ferenci P, Lockwood A, Mullen K, et al. (2002) Hepatic encephalopathy—definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology 35(3):716–721Google Scholar
  7. 7.
    Hotta T, Kobayashi Y, Taniguchi K et al (2004) Surgical treatment for an extrahepatic portosystemic shunt: a case report. Hepatogastroenterology 51(58):1154–1158PubMedGoogle Scholar
  8. 8.
    Pattynama PM, Wils A, van der Linden E et al (2007) Embolization with the Amplatzer Vascular Plug in TIPS patients. Cardiovasc Interv Radiol 30(6):1218–1221CrossRefGoogle Scholar
  9. 9.
    Ferro C, Petrocelli F, Rossi UG et al (2007) Vascular percutaneous transcatheter embolisation with a new device: Amplatzer vascular plug. Radiol Med 112(2):239–251CrossRefPubMedGoogle Scholar
  10. 10.
    Tuite DJ, Kessel DO, Nicholson AA et al (2007) Initial clinical experience using the Amplatzer Vascular Plug. Cardiovasc Interv Radiol 30(4):650–654CrossRefGoogle Scholar
  11. 11.
    Puppala S, Wood A (2008) Re: Initial clinical experience using the Amplatzer Vascular Plug. Cardiovasc Interv Radiol 31(2):444–445CrossRefGoogle Scholar
  12. 12.
    Meyer C, Probst C, Strunk H, et al. (2009) Second-generation Amplatzer Vascular Plug (AVP) for the treatment of subsequent subclavian backflow Type II endoleak after TEVAR. Cardiovasc Interv Radiol [Epub ahead of print]Google Scholar
  13. 13.
    Basile A, Marletta G, Tsetis D et al (2007) The Amplatzer Vascular Plug also for ovarian vein embolization. Cardiovasc Interv Radiol 31(2):446–447CrossRefGoogle Scholar
  14. 14.
    White HA, Travis SJ (2008) The Amplatzer Vascular Plug. Cardiovasc Interv Radiol 31(2):448–449CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2009

Authors and Affiliations

  • Helena Boixadera
    • 1
  • Alejandro Tomasello
    • 2
  • Sergi Quiroga
    • 1
  • Joan Cordoba
    • 3
  • Mercedes Perez
    • 2
  • Antoni Segarra
    • 2
  1. 1.Department of RadiologyHospital Vall d’ HebronBarcelonaSpain
  2. 2.Department of Interventional RadiologyHospital Vall d’ HebronBarcelonaSpain
  3. 3.Department of Internal Medicine-HepatologyHospital Vall d’ HebronBarcelonaSpain

Personalised recommendations