Iatrogenic intrahepatic arterial-portal fistula.

Bedell, Jane E.; Keller, Frederick S.; Rösch, J

doi:10.1148/radiology.151.1.6701341

Cited by 11 publications

(3 citation statements)

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“…Since the first IAPF case reported in 1892 [ 9 ], etiologies include trauma, iatrogenic complications of diagnostic and therapeutic procedures[ 10 ], congenital lesions, arteriovenous shunting within HCC, spontaneous development of a fistula, and so on [ 1 ]. In the present study, the major etiology of IAPFs is HCC, that existed in 61.4% of patients.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic evaluation of arterio-portal fistula-related gastroesophageal variceal bleeding

et al. 2017

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Background & AimsIntrahepatic arterio-portal fistula is an uncommon etiology of portal hypertension, which presents diagnostic and therapeutic challenges. This study aimed to assess the efficacy and outcomes of gastroesophageal variceal bleeding caused by arterio-portal fistula using different therapeutic approaches.MethodsMedical records of 451 consecutive patients with arterio-portal fistula were reviewed from January 1, 2009, to July 15, 2016, and patients suffered variceal bleeding were eligible for the study.ResultsAmong 57 patients with arterio-portal fistula, hepatocellular carcinoma was existed in 61.4% patients. A combination of radiological intervention and endoscopic treatment was performed in 8 (14.0%) patients; the remainder were treated using radiological intervention alone (n = 20, 35.1%), endoscopic treatment alone (n = 18, 31.6%), or without any intervention (n = 11, 19.3%). No patient died in the combination group, while 20 patients in the single-treatment group and 6 in the untreated group died during follow-up. A significant difference in the survival rate was found between the combination group and the other two groups. Treatment selection between combination and untreated groups was the only parameter significantly associated with survival (p = 0.002).ConclusionsFor patients diagnosed with arterio-portal fistula, combination treatment is the most optimal strategy in managing variceal bleeding, especially in patient with severe type of fistula.

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Section: Discussionmentioning

confidence: 99%

Therapeutic evaluation of arterio-portal fistula-related gastroesophageal variceal bleeding

et al. 2017

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“…Successful transcatheter embolization of hepatoportal fistula with absorbable gelatin sponges (Gelfoam, Upjohn) has been described, but embolization with this material seems to be associated with early recanalization ( 4,9,10) or outright failure of occlusion particularly with large fi tulas (2,8). Re ults of embolization with teel coils appear to be more encouraging (8,11,12), but even with this technique there is a report of recanalization and recurrent variceal hemorrhage (9). In circumstances where the fistula cannot be controlled and there are significant symptoms related to portal hypertension, portosystemic shunting may need to be considered (9).…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Hepatoportal Arteriovenous Fistula by Transcatheter Embolization with Steel Coils

Picton

Machan

Davis

et al. 1994

Canadian Journal of Gastroenterology

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Successful treatment of hepatoportal arteriovenous fistula by transcatheter embolization with steel coils. Can J Gastroenterol 1994;8(5):313-316. Portal hyperten ion is most commonly caused by increased intrahepatic resistance as a result of cirrhosis, but can also occur as a result of abnormally high portal bloodflow. Thi article describes a patient with a history of remote liver trauma in whom portal hypertension and variceal bleeding were shown to be due to an arteriovenous fi tula between the hepatic artery and portal vein. Transcatheter embolization with Oianturco coils resulted in obliteration of the fistula and normalization of portal pre sures. Traitement reussi d'une fistule arterioveineuse hepatoportale par embolisation a l'aide d'endoprotheses installees par catheterisme RESUME : L'hypertension portale est le plus souvent causee par une resi ta.nee mtra-hepatique accrue des suites d'une cirrhose, mais elle peut egalement survenir a cause d'un debit sanguin porte anormalement eleve. Cet article decrit un patient presentant des antecedents de traumatisme hepatique ancien, chez qui une hypertension portale et des hemorragies variqueuses se sont revelees attribuables a une fistule arterioveineuse entre l'artere hepatique et la veine porte. Une embolisation par catheter a !'aide d'endoprotheses de Oianturco a provoque une obliteration de la fistule et a normalise les pressions portales.

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“…However, large fistulae with high flow rates can cause or exacerbate portal hypertension, if overlooked. 49 In patients with intrahepatic, subcapsular, or perihepatic hematoma after blunt trauma, the hematoma may compress hepatic sinusoids and venules and obstruct hepatic venous outflow, thereby causing transsinusoidal APS. Doppler sonography is useful to detect HFPF in these patients.…”

Section: Other Tumorsmentioning

confidence: 99%

Hepatofugal portal flow on Doppler sonography in various pathological conditions: A pictorial essay

Hwang

Kim

Choi

et al. 2009

J of Clinical Ultrasound

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Iatrogenic intrahepatic arterial-portal fistula.

Cited by 11 publications

References 0 publications

Therapeutic evaluation of arterio-portal fistula-related gastroesophageal variceal bleeding

Therapeutic evaluation of arterio-portal fistula-related gastroesophageal variceal bleeding

Successful Treatment of Hepatoportal Arteriovenous Fistula by Transcatheter Embolization with Steel Coils

Hepatofugal portal flow on Doppler sonography in various pathological conditions: A pictorial essay

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