title: Intrahepatic portosystemic venous shunt via the right adrenal vein: treatment with vascular plug.
abstract: A 65-year-old man with hepatocellular carcinoma (HCC) due to alcohol-related liver cirrhosis had undergone transarterial chemoembolization 11 times. However, treatment for HCC was difficult to continue, due to episodic hepatic encephalopathy. He was referred to our hospital for treatment of hepatic encephalopathy, showing a Child-Pugh score of 8 despite medical therapy. Abdominal computed tomography revealed intrahepatic portosystemic venous shunt comprising two shunt tracts from the right posterior portal vein to the inferior vena cava via the right adrenal vein. The larger tract was occluded using an Amplatzer Vascular Plug (AVP) II, and the smaller tract was occluded using an original AVP. The postembolization course was uneventful. Hepatic encephalopathy improved after shunt occlusion and no recurrence had occurred as of one year after the procedure.
authors.affiliation: a Departments of Diagnostic and Interventional Radiology , Aichi Cancer Center Hospital , Nagoya , Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Murata
authors.affiliation: a Departments of Diagnostic and Interventional Radiology , Aichi Cancer Center Hospital , Nagoya , Japan.
authors.forename: Yozo
authors.initials: Y
authors.lastname: Sato
authors.affiliation: a Departments of Diagnostic and Interventional Radiology , Aichi Cancer Center Hospital , Nagoya , Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Inaba
authors.affiliation: a Departments of Diagnostic and Interventional Radiology , Aichi Cancer Center Hospital , Nagoya , Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamaura
authors.affiliation: a Departments of Diagnostic and Interventional Radiology , Aichi Cancer Center Hospital , Nagoya , Japan.
authors.forename: Mina
authors.initials: M
authors.lastname: Kato
authors.affiliation: a Departments of Diagnostic and Interventional Radiology , Aichi Cancer Center Hospital , Nagoya , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawada
authors.affiliation: a Departments of Diagnostic and Interventional Radiology , Aichi Cancer Center Hospital , Nagoya , Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: a Departments of Diagnostic and Interventional Radiology , Aichi Cancer Center Hospital , Nagoya , Japan.
authors.forename: Tsubasa
authors.initials: T
authors.lastname: Asai
authors.affiliation: b Division of Interventional Radiology , Shizuoka Cancer Center Hospital , Shizuoka , Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Aramaki
mesh_terms: D000368:Aged; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008113:Liver Neoplasms / Q000209:etiology / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011169:Portal Vein / Q000601:surgery*; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D055989:Septal Occluder Device; D014682:Vena Cava, Inferior / Q000601:surgery*
keywords: Amplatzer Vascular Plug; intrahepatic portosystemic venous shunt; right adrenal vein