Observation on portosystemic collateral vessels with catheterizing in portal vein directly through TIPS in decompensated cirrhotic portal hypertension patients / 中国介入影像与治疗学

ABSTRACT

Objective: To investigate the DSA manifestations of the portosystemic collateral vessels (PSCV) in the patients with decompensated cirrhotic portal hypertension (DCPH) and the feasibility of portovenography performed with catheterizing in the portal vein directly through TIPS. Methods: Totally 274 patients with DCPH who were treated with TIPS were enrolled and retrospectively analyzed. DSA was directly performed with catheterizing in the superior mesenteric vein and splenic vein through TIPS, respectively. DSA manifestations of PSCV were observed and described. And PSCV were classified based on the manifestations. Results: All 274 patients were successfully treated with portal vein angiography and TIPS, and no postoperative complications occurred. According to the origin, PSCV could be classified into four types, including branch of portal vein type (2.55% [7/274]), which were blood to hepatic and mainly by shunt; main portal vein type (23.36% [64/274]), which were blood leaving hepatic with large blood flow; tributaries of the portal vein type (12.77% [35/274]), which were blood leaving hepatic with various ways to systemic circulation; multi-sources type (61.31% [168/274]), which were supplied by multiple origins. Conclusion: Direct portovenography through TIPS is safe and feasible,which can display classification of PSCV, including branch of portal vein type, main portal vein type, tributaries of portal vein type and multi-sources type, all having different hemodynamic characteristics.