Transsplenic Portal System Catheterization: Review of Current Indications and Techniques

Area of Science:

• Interventional Radiology
• Vascular Surgery
• Hepatology

Background:

• Portal vein access is crucial for managing diverse portal system diseases.
• Percutaneous transhepatic and transjugular routes are standard but have limitations.
• Transsplenic access (TSA) is emerging as a viable alternative for challenging cases.

Purpose of the Study:

• To review the indications and techniques of percutaneous transsplenic access (TSA).
• To summarize portal vein diseases necessitating endovascular management.
• To present an imaging-based review of TSA interventions and complications.

Main Methods:

• Review of percutaneous transsplenic access (TSA) techniques.
• Summary of portal vein diseases and their endovascular management.
• Imaging review of technical considerations and potential complications.

Main Results:

• Percutaneous TSA is effective for recanalization, stenosis treatment, embolization, and post-transplant interventions.
• Technical success rates of TSA are comparable to standard methods.
• TSA demonstrates low rates of major procedural complications.

Conclusions:

• Transsplenic access (TSA) is a safe and effective option when traditional portal vein access is contraindicated.
• TSA facilitates a range of endovascular treatments for complex portal system pathologies.
• The technique offers comparable outcomes to established methods with a favorable safety profile.