PMC5368710_01
Abdominal CT before treatment with coil occlusion. Portal venous phase
contrast-enhanced CT of the abdomen shows dilation and curvature of the
portal vein branch (Y) in the left lateral hepatic lobe, with several
tortuous vessels that appeared continuous with the hepatic artery and a
nidus visible around the associated portal vein branch ( ). No portal
vein branch in the right lateral hepatic lobe is evident. Multiple shunt
vessels are seen in the abdominal cavity ( )
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PMC5368710_01_10.1177_2055116916642256-fig1.jpg
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Care]) CT confirmed dilation of a portal vein branch (diameter 6.7 mm) in the left lateral hepatic lobe with several tortuous vessels that appeared continuous with the hepatic artery and a nidus visible around the associated portal vein branch (Figure 1). CT also confirmed the presence of multiple shunt vessels.
Angiography before coil placement. Contrast medium injected into the portal
vein branch immediately diverts into the mesenteric vein and multiple thick
shunts are also evident. Portal venous pressure is 26/24 mmHg (mean pressure
24 mmHg)
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Portal venous pressure was measured and peristaltic movements and colour of the intestines were checked, then five push-up coils (Cook push-up coils: 10 mm, 14.2 cm; Cook Japan) were added in order to embolise the intrahepatic portal vein (Figures 2 and 3).
Angiography after coil placement. The contrast medium injected reaches the
proximal portal vein because the retrograde hepatofugal flow is blocked by
the coils, but the right hepatic parenchyma is not clearly visualised.
Portal venous pressure after coil embolisation is 27/23 mmHg (mean pressure
25 mmHg)
10.1177_2055116916642256-fig3.jpg
PMC5368710_01_10.1177_2055116916642256-fig3.jpg
fig3-2055116916642256
Portal venous pressure was measured and peristaltic movements and colour of the intestines were checked, then five push-up coils (Cook push-up coils: 10 mm, 14.2 cm; Cook Japan) were added in order to embolise the intrahepatic portal vein (Figures 2 and 3).