Comparison of Bleeding Complications between Transplenic versus Transhepatic Access of the Portal Venous System

Haddad, Mustafa M.; Fleming, Chad J.; Thompson, Scott M.; Reisenauer, Christopher J.; Parvinian, Ahmad; Frey, G; Toskich, Beau B.; Andrews, James C.

doi:10.1016/j.jvir.2018.04.033

Cited by 24 publications

(22 citation statements)

References 23 publications

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“…Both TH and TS methods are prone to hemorrhage-related complications. In a study comparing the two methods, the TS group's bleeding rate was 12.5%, and the TH group's bleeding complication rate was 8% [2] .…”

Section: Discussionmentioning

confidence: 99%

Percutaneous microwave ablation for control of massive portal venous bleeding

Jaffan

Huffman

Gueyikian

2020

Radiology Case Reports

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We present a case of a 46 years old female with decompensated liver cirrhosis who developed severe intraperitoneal hemorrhage secondary to inadvertent liver puncture during a paracentesis which resulted in a combined hepatic arterial and portal venous injury. The arterial injury was managed with transarterial embolization. The portal venous injury was managed with percutaneous microwave ablation. This article also highlights the importance of evaluating both arterial injury as well as portal venous injury in the setting of hepatic bleeding, particularly in patients with portal hypertension.

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Section: Discussionmentioning

confidence: 99%

Percutaneous microwave ablation for control of massive portal venous bleeding

Jaffan

Huffman

Gueyikian

2020

Radiology Case Reports

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“…Vein ruptures are rare and generally resolve with temporary balloon occlusion or covered stent placement. Relatively recent data (36) suggest that there is no difference in the low risk of associated bleeding between the transhepatic and transsplenic approaches used for PMV intervention.…”

Section: Pmv Intervention-related Complications-per-mentioning

confidence: 99%

Portomesenteric Venous Complications after Pancreatic Surgery with Venous Reconstruction: Imaging and Intervention

et al. 2020

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Pancreatic surgery with en bloc venous resection and reconstruction is becoming increasingly common in the current era of expanding neoadjuvant oncologic therapies and advanced surgical techniques for patients with more anatomically complex tumors. However, patients who have alterations in their venous outflow are at increased risk for postoperative portomesenteric venous stenosis and/or thrombosis. Cross-sectional imaging for postoperative surveillance, including multiphase CT or MRI, is critical for recognizing portomesenteric venous complications and thus implementing early intervention and preventing complications related to portomesenteric venous hypertension. Hypertension-related complications include ascites, variceal or gastrointestinal bleeding, postprandial abdominal pain, intestinal edema, protein-losing enteropathy, malabsorptive diarrhea, and splenomegaly. Percutaneous transhepatic, transsplenic, and transjugular portomesenteric interventions, including venoplasty, stent placement, and thrombectomy or thrombolysis, are safe and effective options for restoring patency to the portomesenteric venous system. Preintervention CT or MRI and diagnostic catheter venography are important for procedural planning, while postintervention CT or MRI surveillance is critical for detecting recurrent stenosis or thrombosis, or de novo portomesenteric venous disease.

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“…Optimising routes of delivery Whilst intrasplenic injection is commonly used to access the portal circulation in animal models, the portal vein is typically accessed via 3 routes in humans; ultrasound-guided transcutaneous puncture of an intrahepatic portal vein tributary, intrahepatic transcutaneous splenic vein tributary puncture or via the hepatic venous system with a transjugular intrahepatic portosystemic shunt. These procedures are associated with a bleeding risk, [38][39][40] compounded by impaired primary haemostasis which can accompany liver failure. Portal vein hypertension frequently accompanies chronic liver disease (CLD), which may progress to the development of portosystemic shunting through varices, reversal of portal vein flow, or portal vein thrombosis, impeding delivery of cells to the liver via this route.…”

Section: Overcoming the Challenges Of Cell Therapy For Liver Diseasementioning

confidence: 99%

Cell therapy for advanced liver diseases: Repair or rebuild

Dwyer¹,

Macmillan²,

Brennan³

et al. 2021

Journal of Hepatology

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Advanced liver disease presents a significant worldwide health and economic burden and accounts for 3.5% of global mortality. When liver disease progresses to organ failure the only effective treatment is liver transplantation, which necessitates lifelong immunosuppression and carries associated risks. Furthermore, the shortage of suitable donor organs means patients may die waiting for a suitable transplant organ. Cell therapies have made their way from animal studies to a small number of early clinical trials. Herein, we review the current state of cell therapies for liver disease and the mechanisms underpinning their actions (to repair liver tissue or rebuild functional parenchyma). We also discuss cellular therapies that are on the clinical horizon and challenges that must be overcome before routine clinical use is a possibility.

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Comparison of Bleeding Complications between Transplenic versus Transhepatic Access of the Portal Venous System

Cited by 24 publications

References 23 publications

Percutaneous microwave ablation for control of massive portal venous bleeding

Percutaneous microwave ablation for control of massive portal venous bleeding

Portomesenteric Venous Complications after Pancreatic Surgery with Venous Reconstruction: Imaging and Intervention

Cell therapy for advanced liver diseases: Repair or rebuild

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