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Preloading Coil in Plug Method (p-CIP) with the AVP 2 for large Portosystemic Shunt Embolization
Kazuki Hashimoto1, Yukihisa Ogawa1, Shinji Wada1
1Department of Radiology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan.
Radiology Case Reports
|August 17, 2021
Summary
Hepatic encephalopathy from large portosystemic shunts (PSS) can be treated with embolization. A novel preloading coil in plug (p-CIP) method using an Amplatzer vascular plug 2 (AVP2) successfully treated a complex PSS case.
Area of Science:
- Interventional Radiology
- Hepatology
- Vascular Surgery
Background:
- Hepatic encephalopathy (HE) is a serious complication of liver cirrhosis, often caused by portosystemic shunts (PSS).
- Endovascular embolization is a treatment option for PSS, but large shunts (>20 mm) can present technical challenges.
Observation:
- A 72-year-old woman with liver cirrhosis, hyperammonemia, and a large spleno-renal shunt underwent embolization.
- The procedure utilized an Amplatzer vascular plug 2 (AVP2) and metallic coils.
Findings:
- The preloading coil in plug (p-CIP) method was employed to facilitate embolization within the AVP2 without external cannulation.
- This technique successfully overcame technical difficulties associated with the large shunt size.
Implications:
- The p-CIP method with AVP2 offers a viable solution for treating complex PSS causing hepatic encephalopathy.
- This approach may improve outcomes for patients with challenging shunt anatomy.
