Embolization of a paraumbilical shunt by the transparaumbilical venous approach and one-sheath inverse method: A case report

Hiroki Kamada, Hideki Ota, Kazumasa Seiji, Kei Takase

Research output: Contribution to journalArticlepeer-review

Abstract

We describe treatment of a 53-year-old man with chronic hepatic encephalopathy. Contrast-enhanced computed tomography demonstrated a recanalized paraumbilical vein as a portosystemic shunt connecting the left branch of the portal vein and bilateral iliac veins. Percutaneous embolization was performed. The paraumbilical vein was punctured under ultrasonographic guidance; a 7-Fr sheath was inserted in the cranial direction. The hepatic side of the shunt was embolized with a vascular plug. The sheath direction was inverted to the caudal side; the pelvic side of the shunt was then embolized with another vascular plug. This report demonstrates that the percutaneous transparaumbilical venous approach is useful and safe for portosystemic shunt intervention. Moreover, the one-sheath inverse method was useful for embolization of upstream and downstream sides of the puncture site.

Original languageEnglish
Pages (from-to)2125-2128
Number of pages4
JournalRadiology Case Reports
Volume15
Issue number11
DOIs
Publication statusPublished - 2020 Nov

Keywords

  • Hepatic encephalopathy
  • One-sheath inverse method
  • Portal hypertension
  • Portosystemic shunt
  • Transparaumbilical venous approach

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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