PMC8118526_01
Interventional venogram demonstrating portal systemic varix with inflow from left renal vein and extravasation of contrast into distal duodenum. Annotations as follows: I: IVC, II: Left renal vein, III: left gonadal vein, IV: extravasation of contrast into duodenum, V: Duodenal ectopic varix, Arrow: efferent flow from DEV into the left renal vein prior to DEV submucosal erosion
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On HD 3 interventional radiology performed a transcatheter angiogram and venogram which demonstrated a portal systemic varix with prominent inflow into the mid-left renal vein (Figure 1).
Venogram of distal duodenal ectopic varix status post varix outflow embolization with 0.35 interlock coil on HD3. Annotations as follows: I: IVC, II: Left renal vein, III: left gonadal vein, IV: absence of contrast into duodenum, V: 0.35 interlock coil filling DEV and outflow, absence of contrast distally in afferent feeders of DEV
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The varix outflow was embolized with multiple 0.35 interlock coils (Figure 2).
Fluoroscopy demonstrating successful microcoil placement in a medial branch of the superior mesenteric vein feeding the ectopic varix. Annotations as follows: I: medial branch of superior mesenteric vein, II: microcoil placement obstructing DEV afferent vein, III: previously deployed 0.35 interlock coil
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A repeat angiogram was performed of the superior mesenteric vein confirming thrombosis of the treated vessel (Figure 3).