Diagnosis of an accessory portal vein and its clinical implications for portosystemic shunts.
OBJECTIVE
To present a peculiar anatomic portal veins variant and evaluate its clinical implications.


METHODS
Among 118 consecutive patients undergoing transjugular intrahepatic portosystemic shunting (TIPS), six male patients were found to have an accessory portal vein, which was seen during direct portography.R ESULTS: In all six patients, portograms showed an accessory small-caliber vein parallel to the trunk of the main portal vein ending in the right lobe of the liver. Two of the six accessory portal veins drained blood from coronary veins, precluding access to coronary vein embolization during TIPS.


CONCLUSIONS
An accessory portal vein is a rare anatomical variation with clinical significance for both surgical shunt placement and TIPS, as well as for transportal embolization of coronary veins.
Zhang
J S
JS
Department of Diagnostic Radiology, General Hospital of PLA, Beijing 100853, P. R. China.
Wang
Y P
YP
Wang
M Q
MQ
Yang
L
L
Xing
C C
CC
Yu
M
M
Cui
Z
Z
D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging; D011170:Portasystemic Shunt, Surgical; D011172:Portography