Portal venous remodeling after endovascular reduction of pediatric autogenous portosystemic shunts

Jessica K. Stewart, William T. Kuo, David M. Hovsepian, Lawrence V. Hofmann, Clark A. Bonham, Daniel Y. Sze

Research output: Contribution to journalArticle

Abstract

Patients with autogenous native vessel portosystemic shunts, whether surgical or congenital, may experience complications of excess shunt flow, including hepatopulmonary syndrome (HPS), hepatic encephalopathy (HE), and hepatic insufficiency. The authors explored endovascular reduction or occlusion of autogenous portosystemic shunts using methods commonly employed in transjugular intrahepatic portosystemic shunt (TIPS) reduction in four pediatric patients. Before treatment, the patients had hypoplastic, atrophic, or thrombosed portal veins. Following intervention, symptoms of overshunting resolved or improved in all patients without major complications. The innate plasticity of the pediatric portal venous system allowed for hypertrophy or development and maturation of cavernous transformations to accommodate increased hepatopetal blood flow and pressure.

Original languageEnglish (US)
Pages (from-to)1199-1205
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume22
Issue number8
DOIs
StatePublished - Aug 1 2011

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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