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Outcome of four cats with congenital intrahepatic portosystemic shunts treated by a modified percutaneous transvenous
Kornelia Tiffinger1,2, Erin Gibson1, Justin Ganjei3
1University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA.
Insights
A modified single-catheter technique for percutaneous transvenous coil embolization (PTCE) in cats successfully treated intrahepatic shunts. This approach avoids complications from large vascular sheaths, offering a viable alternative for feline patients.
Area of Science:
- Veterinary Medicine
- Interventional Radiology
- Cardiovascular Surgery
Background:
- Congenital intrahepatic shunts (cIHPSS) require interventional treatment.
- Standard percutaneous transvenous coil embolization (PTCE) uses large sheaths (9 Fr) challenging for feline vascular access.
- Large sheaths can lead to venous trauma and other complications in cats.
Purpose of the Study:
- To describe a modified single-catheter PTCE technique in cats.
- To evaluate the safety and outcomes of this modified technique.
- To avoid complications associated with large vascular sheaths in feline PTCE.
Main Methods:
- Retrospective case series of four cats with left divisional cIHPSS.
- Single-catheter PTCE performed via a 6Fr jugular venous sheath.
- Used a 4Fr Berenstein catheter for imaging, pressure measurement, and coil deployment.
Main Results:
- The modified technique was successfully performed in all four cats.
- No complications related to venous trauma or portal hypertension were reported.
- Procedural duration was reasonable.
Conclusions:
- The modified single-catheter PTCE technique is a viable alternative for treating feline cIHPSS.
- This method mitigates risks associated with large vascular sheaths in cats.
- It offers a potentially safer approach for interventional procedures in small-breed animals.
Abstract:
Case series summarySimultaneous portogram/cavogram and continuous portal pressure monitoring during coil deployment are standard practices during percutaneous transvenous coil embolization (PTCE) for the interventional treatment of congenital intrahepatic portosystemic shunts (IHPSSs). In cats, vascular access is more challenging because of their smaller size. The minimum vascular sheath size required to accommodate standard instrumentation for dual-catheter PTCE is 9 Fr, which can be challenging to place in the feline jugular vein. The objective of this case series was to retrospectively describe a single-catheter modification of the PTCE technique in cats to avoid complications associated with large vascular sheaths and the outcomes of these cats. Four cats from two different institutions underwent single-catheter PTCE for left divisional IHPSSs between January 2024 and May 2025. Data collected from medical records included patient demographic data and peri- and post-procedural data. Single-catheter PTCE was performed in all cats through a 6 Fr vascular sheath percutaneously placed in the jugular vein. Isolated portogram and cavogram were performed to localize the shunt, measure caval diameter and determine caval stent positioning using a 4 Fr Berenstein catheter. A laser-cut stent was selected based on CT and cavogram measurements and positioned to span the shunt ostium. The same Berenstein catheter was used for portal pressure measurement and coil deployment by alternating between the shunt and portal vein locations. No complications associated with venous trauma or portal hypertension were reported.Relevance and novel informationThe case series results suggest the modified PTCE technique is a viable alternative that was associated with reasonable procedural duration and avoided vascular complications that may be associated with large vascular sheaths in cats.
