Percutaneous transhepatic obliteration of a large portosystemic shunt associated with hepatic encephalopathy using a technique of n-butyl-2-cyanoacrylate injection inside hydrogel-coated coils: A case report

Radiology Case Reports

article

Yosuke Nozawa¹  Koichi Masuda¹  Tadashi Katayama¹  Yuko Kobashi¹  Koshi Ikeda¹  Taiga Suzuki¹  Takeshi Fukuda¹ 

[1] Department of Radiology, Tokyo Dental College Ichikawa General Hospital

关键词: Hepatic encephalopathy;    Percutaneous transhepatic obliteration;    n-butyl-2-cyanoacrylate;    Hydrogel-coated coil;   

DOI  :  10.1016/j.radcr.2022.09.041

学科分类：生物化学工程

来源: University of Washington * Department of Radiology

【 摘 要 】

Portosystemic shunts with cirrhosis may lead to hepatic encephalopathy (HE), which is often pharmacotherapy-resistant. We report a case of a 66-year-old female patient diagnosed with alcoholic cirrhosis and uncontrolled HE. She underwent percutaneous transhepatic obliteration (PTO) for treatment of a large portosystemic shunt from the left and right gastric veins to the azygos vein. We embolized the target veins using hydro-coated coils and filled them with n-butyl-2-cyanoacrylate (NBCA), leading to firmed obstruction of the large portosystemic shunt without NBCA migration, thus reducing the number of coils required. The HE symptoms improved after PTO and could thereafter be controlled with conservative therapy. Our results showed that PTO using an NBCA injection inside hydrogel-coated coils for a large portosystemic shunt associated with HE is effective and safe.

【 授权许可】

CC BY|CC BY-NC-ND