Direct Percutaneous Abdominal Venous Access for Endovascular Therapy

Area of Science:

• Interventional Radiology
• Vascular Surgery
• Medical Imaging

Background:

• Vascular malformations often require complex treatment strategies.
• Accessing deep intraabdominal veins can be challenging for embolization procedures.

Purpose of the Study:

• To assess the feasibility, safety, and clinical utility of ultrasound-guided direct percutaneous access to ectatic abdominal veins.
• To evaluate this technique for embolizing vascular malformations.

Main Methods:

• Retrospective review of medical records, imaging, and procedural data.
• Analysis of patients undergoing embolization for vascular malformations via ultrasound-guided percutaneous access to intraabdominal veins.
• Inclusion of pelvic, retroperitoneal, and portomesenteric veins.

Main Results:

• 38 direct percutaneous accesses in 25 procedures across 9 patients (ages 3-58).
• Successful access to various intraabdominal veins including retroperitoneal and mesenteric veins.
• All procedures were technically successful with seven minor, conservatively managed complications.

Conclusions:

• Ultrasound-guided percutaneous access to dilated intraabdominal veins is feasible and safe.
• This method demonstrates minimal morbidity and offers a valuable alternative for complex vascular malformations.
• It facilitates access to deep abdominal veins when other methods are unsuitable.