title: Endovascular evaluation and treatment of intrahepatic portosystemic shunts in dogs: 100 cases (2001-2011).
abstract: OBJECTIVE
  To evaluate short- and long-term outcome following endovascular treatment of intrahepatic portosystemic shunts in dogs.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  100 dogs.
  
  
  METHODS
  All patients had angiographic evaluation with or without endovascular shunt attenuation. The medical records were reviewed for pertinent data, complications, outcome, and survival time.
  
  
  RESULTS
  95 dogs with congenital intrahepatic portosystemic shunts received 111 procedures (83% [79/95] had 1 treatment, and 17% [16/95] had > 1 treatment; 5 dogs had no treatment because of excessive portal venous pressure-central venous pressure gradients). Angiography identified 38 right, 33 left, and 19 central divisional single shunts (n = 90) and 10 complex or multiple shunts. Partial shunt attenuation was performed in 92 dogs by means of caval stent placement and insertion of thrombogenic coils within the shunt, and 3 had complete acute shunt occlusion. Major intraoperative complications (3/111 [3%]) included temporary severe portal hypertension in 2 dogs and gastrointestinal hemorrhage in 1 dog. Major postoperative (< 1 week after surgery) complications (14/111 [13%]) included seizures or hepatoencephalopathy (7/111 [6%]), cardiac arrest (2/111 [2%]), jugular site bleeding (2/111 [2%]), pneumonia (1/111 [1%]), suspected portal hypertension (1/111 [1%]), and acute death (1/111 [1%]). Median follow-up time was 958 days (range, 0 to 3,411 days). Median survival time for treated dogs was 2,204 days (range, 0 to 3,411 days). Outcome was considered excellent (57/86 [66%]) or fair (13/86 [15%]) in 70 of 86 (81%) treated dogs.
  
  
  CONCLUSIONS
  Results suggested that endovascular treatment of intrahepatic shunts in dogs may result in lower morbidity and mortality rates, with similar success rates, compared with previously reported outcomes for open surgical procedures. Gastrointestinal ulceration was a common finding among this population of dogs, and lifelong gastroprotectant medications are now recommended.
authors.affiliation: Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, 510 E 62nd St, New York, NY 10065.
authors.forename: Chick
authors.initials: C
authors.lastname: Weisse
authors.forename: Allyson C
authors.initials: AC
authors.lastname: Berent
authors.forename: Kimberly
authors.initials: K
authors.lastname: Todd
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Solomon
authors.forename: Constantin
authors.initials: C
authors.lastname: Cope
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D057510:Endovascular Procedures / Q000379:methods / Q000662:veterinary*; D005260:Female; D008297:Male; D011168:Portal System / Q000002:abnormalities* / Q000601:surgery; D011169:Portal Vein / Q000002:abnormalities* / Q000601:surgery; D012189:Retrospective Studies