CT Arterioportography for Complex Portomesenteric Venous Interventions

Kausthubh Hegde; Patrick D. Sutphin; Zubin Irani; Sanjeeva P. Kalva

doi:10.1055/s-0043-1775855

Journal of Clinical Interventional Radiology ISVIR, Table of Contents

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

¹Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States

,

Patrick D. Sutphin

¹Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States

,

Zubin Irani

¹Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States

,

Sanjeeva P. Kalva

¹Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States

› Author Affiliations

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

Full Text

References

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