Percutaneous transsplenic catheterization of the portal venous system

To evaluate the safety and feasibility of transsplenic portal vein catheterization.

Under ultrasonic guidance, percutaneous transsplenic splenic vein catheterization was performed in 17 patients. Two of the patients had minimal and 5 moderate ascites. In 11 patients, the platelet counts were over 50000/mm3 and the coagulation time normal or mildly prolonged, while 6 patients had either platelet counts of less than 50000/mm3 or moderately prolonged coagulation level.

Transsplenic portal catheterizations were successfully performed in 16 of the 1/patients (one failed because of small splenic size). Procedure-related complications occurred in 3 patients with 2 requiring one unit of packed RBC transfusion. The third patient accumulated minimal fluid in the left pleural space. Imaging studies within one week of the procedure were made in 8 patients. These examinations revealed an intrasplenic hematoma in 2 patients. One patient had a small amount of hemoperitoneum. No major complications occurred.

Transsplenic portal venous catheterization is a safe and feasible procedure.