Direct Percutaneous Abdominal Venous Access for Endovascular Therapy

To evaluate the feasibility, safety, and clinical applications of ultrasound-guided direct percutaneous access to ectatic abdominal veins for the embolization of vascular malformations.

Medical records, imaging studies, and procedural details were retrospectively reviewed for patients who underwent embolization procedures for vascular malformations with ultrasound-guided percutaneous access to intra-abdominal veins, including the pelvic, retroperitoneal, and portomesenteric veins.

A total of 38 direct percutaneous vein accesses were performed across 25 procedures in 9 patients (age range, 3-58 years). Access sites included retroperitoneal veins (n = 12), dilated and tortuous internal iliac vein branches (n = 8), the superior mesenteric vein (n = 8), the inferior mesenteric vein (n = 1), ileocolic vein (n = 8), and right colic vein (n = 1). Catheter sizes ranged from 3F to 5F. All procedures were technically successful. Seven minor access-related complications occurred; all were managed conservatively.

Ultrasound-guided percutaneous access to dilated intra-abdominal veins is feasible and associated with minimal morbidity. It offers a valuable alternative for patients with complex vascular malformations requiring access to deep abdominal veins.