Haemodynamic changes in the liver under balloon occlusion of a portal vein branch—evaluation with single-level dynamic computed tomography during hepatic arteriography

2007 ◽  
Vol 62 (6) ◽  
pp. 579-586 ◽  
Author(s):  
Y. Komada ◽  
S. Murata ◽  
H. Tajima ◽  
S. Kumita ◽  
H. Kanazawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Portal Vein ◽  
Balloon Occlusion ◽  
Dynamic Computed Tomography ◽  
Hepatic Arteriography ◽  
Portal Vein Branch ◽  
Single Level ◽  
Haemodynamic Changes

Portal Vein Tract Embolization After Percutaneous Transhepatic Biliary Interventions

2018 ◽  
Author(s):  
Kazim Narsinh ◽  
Steven C. Rose ◽  
Thomas Kinney
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Arterial Embolization ◽  
Bleeding Complications ◽  
Hepatic Arteriography ◽  
Portal Vein Branch ◽  
Vein Access ◽  
Suitable Target ◽  
Hepatic Artery Branch ◽  
Artery Branch

Bleeding complications during percutaneous biliary intervention result from injury to the hepatic artery, hepatic vein, or portal vein. If bleeding originating from a hepatic artery branch is suspected, hepatic arteriography should be performed with and without the drainage catheter in place over a wire, and subselective embolization can be performed if a suitable target is identified. If a bleeding hepatic artery branch is not identified, bleeding from a portal vein branch is suspected. Treatment of portal vein injuries is challenging in this situation because obtaining direct percutaneous portal vein access is ill-advised. Although injuries to the hepatic artery or vein can often be treated by tract tamponade or arterial embolization, iatrogenic communication between the portal vein and biliary system can be difficult to treat effectively. This chapter presents a method to identify portal vein-to-biliary tract communications via cholangiography, with subsequent embolization via the transhepatic tract.

scholarly journals Morphometric Characteristics of the Portal Vein According to Multispiral Computed Tomography

2021 ◽  
Vol 9 (4) ◽  
pp. 38-44
Author(s):  
A. V. Kolsanov ◽  
M. N. Myakotnykh ◽  
A. A. Mironov ◽  
E. I. Kanaev
Keyword(s):  
Computed Tomography ◽  
Portal Vein ◽  
Abdominal Cavity ◽  
Age Groups ◽  
The Elderly ◽  
Morphometric Characteristics ◽  
Portal Vein Branch ◽  
Computed Tomography Images ◽  
Linear Dimensions

The article discusses the variability of the linear dimensions of the portal vein depending on gender and age. In modern foreign and Russian literature, there is no uniform information about the variant portal vein anatomy. Data on the extreme forms and on the range of anatomical differences in the portal vein vary considerably. All this requires the need for a more detailed study of the morphometric characteristics of the portal vein branch. Computed tomography, in contrast to dissection on a corpse, allows an in vivo study of various morphometric characteristics of the portal vein.The aim of the study is to identify patterns of variability in the linear dimensions of the portal vein in persons of different sex and age.Material and methods. The study material consisted of multispiral computed tomography images of the abdominal cavity with contrast enhancement taken in 100 patients. The study included results of 56 men and 44 women, divided into 4 age groups: 1) first mature age, 2) second mature age, 3) the elderly, 4) the senile. The length of the portal vein was measured between the angle formed at the junction of the superior mesenteric and splenic veins and the angle formed by the branches of the portal vein at the hepatic hilum. The diameter of the vessel was measured at the midpoint of the distance between the proximal and distal points.Results. The length of the portal vein in the general sample was 66.45±8.49 mm, and its diameter was 11.84±1.93 mm. In women, the length of the portal vein was 64.37±6.6 mm, and its diameter was 11.33±1.83 mm, respectively. In men, both the length and diameter of the black vein were significantly greater than in women and constituted 68.09±9.4 mm and 12.24±1.91 mm, respectively. No statistically significant correlation of the studied parameters with age was detected.

scholarly journals Efficacy and Safety of Percutaneous Transhepatic Portal Embolization with Dehydrated Ethanol

2014 ◽  
Vol 8 (1) ◽  
pp. 22-28
Author(s):  
Ryota Hanaoka ◽  
Tatsuo Banno ◽  
Ryoichi Kato ◽  
Hokuto Akamatsu ◽  
Hiroshi Toyama
Keyword(s):  
Portal Vein ◽  
Liver Volume ◽  
Balloon Occlusion ◽  
Efficacy And Safety ◽  
Liver Lobe ◽  
Portal Vein Branch ◽  
Percutaneous Transhepatic Portal Embolization ◽  
Percent Increase ◽  
Before And After ◽  
Portal Embolization

Purpose: The efficacy and safety of percutaneous transhepatic portal embolization (PTPE) with dehydrated ethanol was determined by measuring the liver lobe volume before and after the procedure. Materials and Methods: A total of 38 patients (25 men, 13 women; mean age: 62.0 ± 10.8 years) who underwent PTPE with dehydrated ethanol between April 2005 and March 2011 participated in this study. Dehydrated ethanol containing 17% lipiodol was injected into the target portal vein branch under balloon occlusion, and the portal vein was subsequently embolized. The liver lobe volume was measured via contrast-enhanced computed tomography, and the percent increase in the unembolized lobe volume was then calculated. In addition, PTPE-related complications were surveyed, and the procedural safety was evaluated. Results: The mean percent increase in the unembolized lobe volume after PTPE was 33.8% ± 20.2%. The procedure could not be completed in one patient because of an insufficient increase in the unembolized lobe volume. No serious post- PTPE complications were observed. Conclusion: These data suggest that PTPE with dehydrated ethanol is a safe and effective method for enlarging the planned residual liver volume before extensive liver resection.

scholarly journals Value of preoperative computed tomography for meso-Rex bypass in children with extrahepatic portal vein obstruction

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Huiying Wu ◽  
Ning Zhou ◽  
Lianwei Lu ◽  
Xiwen Chen ◽  
Tao Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Portal Vein ◽  
Predictive Value ◽  
Extrahepatic Portal Vein Obstruction ◽  
Portal Vein Obstruction ◽  
Left Portal Vein ◽  
History Of ◽  
Associated Malformations ◽  
Sensitivity Specificity

Abstract Background Extrahepatic portal vein obstruction (EHPVO) is the most important cause of hematemesis in children. Intrahepatic left portal vein and superior mesenteric vein anastomosis, also known as meso-Rex bypass (MRB), is becoming the gold standard treatment for EHPVO. We analyzed the value of preoperative computed tomography (CT) in determining whether MRB is feasible in children with EHPVO. Results We retrieved data on 76 children with EHPVO (50 male, 26 female; median age, 5.9 years) who underwent MRB (n = 68) or the Warren procedure (n = 8) from 2013 to 2019 and retrospectively analyzed their clinical and CT characteristics. The Rex recess was categorized into four subtypes (types 1–4) depending on its diameter in CT images. Of all 76 children, 7.9% had a history of umbilical catheterization and 1.3% had leukemia. Sixteen patients (20 lesions) had associated malformations. A total of 72.4% of Rex recesses could be measured by CT, and their mean diameter was 3.5 ± 1.8 mm (range 0.6–10.5 mm). A type 1, 2, 3, and 4 Rex recess was present in 9.2%, 53.9%, 11.8%, and 25.0% of patients, respectively. MRB could be performed in patients with types 1, 2, and 3, but those with type 4 required further evaluation. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CT were 100%, 83.8%, 42.1%, 100%, and 85.5%, respectively. Conclusions Among the four types of Rex recesses on CT angiography, types 1–3 allow for the performance of MRB.

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