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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2024; 08(01): 044-048
DOI: 10.1055/s-0043-1775855
Case Report

CT Arterioportography for Complex Portomesenteric Venous Interventions

Kausthubh Hegde 
1   Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
,
Patrick D. Sutphin
1   Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
,
Zubin Irani
1   Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
,
Sanjeeva P. Kalva
1   Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
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Abstract

Authors report the use of computed tomography arterioportography (CTAP) in the diagnosis and endovascular treatment of portomesenteric venous occlusion. Three patients (2 male and 1 female; median age: 51 years) with an extrahepatic portal or mesenteric venous occlusion and variceal bleeding were included in this institutional review boards-approved retrospective study. CTAP was performed with an angiographic catheter positioned in the proximal superior mesenteric artery, and CT was obtained during the venous phase following the intra-arterial injection of contrast material. CTAP provided excellent opacification and delineation of portomesenteric veins, including occlusion length, intravascular webs, venous collaterals, and bleeding varices. This enabled preoperative planning for complex recanalization or extra-anatomic bypass to treat extrahepatic portal and mesenteric venous obstruction. There were no complications related to CTAP.

Keywords

CT arterioportography - porto-mesenteric venous disease - variceal bleeding - transjugular intrahepatic portosystemic shunt - mesenteric venous stent


Publication History

Article published online:
19 October 2023

© 2023. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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