Skip to main content


Log in

Intrahepatic arterioportal fistulae: Role of transcatheter embolization

  • Clinical Investigations
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript


Management of 26 arterioportal fistulae (APFs) is reported. Among 13 hepatoma-induced fistulae (group A), conservative treatment was inefective in 8 patients, and arterial embolization alleviated portal hypertension in the other 5. Of 10 iatrogenic APFs (group B), the 3 largest were successfully embolized, the remaining lesions resolved spontaneously. Three spontaneous nonmalignant APFs (group C) were embolized. Excellent results were obtained in 2 patients, and the other died of severe postembolization hepatic failure. Because long-standing APFs may cause severe portal hypertension with consequent variceal bleeding they should be treated. Arterial embolization is indicated in most patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Morse SS, Sniderman KW, Galloway S, Rappoport S, Ross GR, Glickman MG (1985) Hepatoma, arterioportal shunting and hyperkinetic portal hypertension: Therapeutic embolization. Radiology 155:77–82

    PubMed  CAS  Google Scholar 

  2. Strodel WE, Eckhauser FE, Lemmer JH, Whitehouse WM, Williams DM (1987) Presentation and perioperative management of arterioportal fistulas. Arch. Surg 122:563–571

    PubMed  CAS  Google Scholar 

  3. Van Way CW, Grabe JM, Riddell DH, Foster JH (1971) Arteriovenous fistula in the portal circulation. Surgery 70:876–890

    PubMed  Google Scholar 

  4. Nagasue N, Inokuchi K, Kobayashi M, Saku M (1977) Hepatoportal arteriovenous fistula in primary carcinoma of the liver. Surg Gynecol Obstet 145:504–508

    PubMed  CAS  Google Scholar 

  5. Borisova NA, Ryzhkov VK, Borisov AE, Gapchenko EM (1989) Arterioportale Fisteln als Folge einer percutanen transhepatischen Katheterisierung der Vena portae. Radiol Diagn (Berl) 30:165–170

    CAS  Google Scholar 

  6. Keller FS, Rösch J (1985) Percutaneous management of iatrogenic arterial venous fistulas by coil spring occlusion. Eur J Radiol 5:202–205

    PubMed  CAS  Google Scholar 

  7. Itzchak Y, Adar R, Bogokowski H, Mozes M, Deutsch V (1974) Intrahepatic arterial portal communications: Angiographic study. AJR 121:384–387

    CAS  Google Scholar 

  8. Winograd J, Palubinskas AJ (1977) Arterio-portal venous shunting in cavernous hemangioma of the liver. Radiology 122:331–332

    PubMed  CAS  Google Scholar 

  9. Applbaum YN, Renner JW (1987) Steel coil embolization of hepatoportal fistulae. Cardiovasc Intervent Radiol 10:75–79

    Article  PubMed  CAS  Google Scholar 

  10. Tisnado J, Bezirdjian DR (1990) Transcatheter therapy of iatrogenic vascular injuries to the liver. Semin Intervent Radiol 7:263–274

    Google Scholar 

  11. Okuda K, Obata H, Nakajima Y, Ohtsuki T, Okazaki N, Ohnishi K (1984) Prognosis of primary hepatocellular carcinoma. Hepatology 4 (Suppl):3S-6S

    Article  PubMed  CAS  Google Scholar 

  12. Ryzhkov VK, Borisova NA, Gapchenko EM, Dmitrijeva IA (1988) Verschluß von Arterien durch vergrößerte Spiralembolisate. Radiol Diagn (Berl) 29:713–717

    Google Scholar 

  13. Lunderquist A, Vang J (1974) Transhepatic catheterization and obliteration of the coronary vein in patients with portal hypertension and esophageal varices. New Engl J Med 291:646–649

    Article  PubMed  CAS  Google Scholar 

  14. Mays ET (1977) Vascular occlusion. Surg Clin North Am 57:291–323

    PubMed  CAS  Google Scholar 

  15. Savastano S, Feltrin GP, Miotto D, Chiesura-Corona M, Rubaltelli L, Candiani F (1989) Vascular parenchymal sources of upper gastrointestinal bleeding. Acta Radiologica 30:39–43

    Article  PubMed  CAS  Google Scholar 

  16. Kerlan RK, Bank WO, Hoddik WK, Pogany AC, Sollenberger RD (1983) Occlusion of a hepatic artery to portal vein fistula with Bucrylate. Cardiovasc Intervent Radiol 6:138–140

    Article  PubMed  Google Scholar 

  17. Mallarini G, Saitta S, Cariati M, Nicorelli M, DeCaro G (1982) Embolization of AV intrahepatic fistulas. Eur J Radiol 2:152–156

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and permissions

About this article

Cite this article

Tarazov, P.G. Intrahepatic arterioportal fistulae: Role of transcatheter embolization. Cardiovasc Intervent Radiol 16, 368–373 (1993).

Download citation

  • Issue Date:

  • DOI:

Key words