title: Interventional embolization of congenital intrahepatic shunts in children.
abstract: BACKGROUND
  Congenital intrahepatic shunts in children are rare and precise treatment strategies have not been established.
  
  
  OBJECTIVE
  The purpose of this study was to present our experience with transcatheter embolization in a descriptive case series of congenital intrahepatic shunts in children.
  
  
  METHODS
  We retrospectively studied 10 children with symptomatic congenital intrahepatic shunts who were treated with embolization at our institute between January 2008 and December 2014.
  
  
  RESULTS
  Seven children had arteriovenous shunts in association with hepatic hemangiomas, two had arterioportal shunts and one had portosystemic shunts. The major presentations were congestive heart failure and severe anemia in the groups with arteriovenous and arterioportal shunts, respectively. Following embolization, two children died in the arteriovenous group, one from progressive liver dysfunction and the other from abdominal compartment syndrome. One child in the arterioportal group required liver transplantation after initial embolization. With mean post-procedure follow-up of 15 months (range 4-54 months), all the remaining children were well, with resolution of the symptoms.
  
  
  CONCLUSIONS
  Interventional embolization provides an alternative to surgical ligation or hepatic resection in children with clinically significant intrahepatic shunts. For lesions with complex morphology, embolization may be inadequate and liver transplantation might be the only therapeutic option.
authors.affiliation: Cathererization Laboratory, Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wu
authors.affiliation: Cathererization Laboratory, Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Cathererization Laboratory, Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Cathererization Laboratory, Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Lan
authors.initials: L
authors.lastname: He
authors.affiliation: Department of Radiology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China. huxihong777@163.com.
authors.forename: Xihong
authors.initials: X
authors.lastname: Hu
mesh_terms: D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006499:Hepatic Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods
keywords: Arterioportal fistula; Child; Congenital; Embolization; Hepatic hemangioma; Interventional radiology; Intrahepatic shunt; Portosystemic shunt