Outcomes of cellophane banding or percutaneous transvenous coil embolization of canine intrahepatic portosystemic shunts

Abstract

CB and PTCE are associated with similar short-term and intermediate-term survival. PTCE is a minimally invasive alternative to CB via celiotomy. However, CB allows concurrent abdominal procedures requiring the same approach.

Effect of prophylactic treatment with levetiracetam on the incidence of postattenuation seizures in dogs undergoing surgical management of single congenital extrahepatic portosystemic shunts

“…We acknowledge that there is an important reliance on owners to administer antiseizure medication at home. We defined PAS as seizures that occurred within 7 days postoperatively, in accordance with what has been reported in the literature . Occurrence of seizures was recorded up to 128 hours postoperatively in our study.…”

“…Incidence of PAS has been reported as high as 18.2% and up to 4.7%‐8.1% in more recent literature . Seizures typically occur within 96 hours postoperatively and have been reported after congenital extrahepatic portosystemic shunt (cEHPSS) and, less commonly, intrahepatic portosystemic shunt (cIHPSS) attenuation . Such seizures appear different from those observed preoperatively in that they are often very challenging to control, often being refractory to typical first‐line antiseizure medications …”

“…Risk factors for development of PAS are not well established . Development of seizures has not been prevented by partial ligation, use of delayed attenuation devices, or coil embolization . In a recent study, increasing age and the presence of hepatic encephalopathy (HE) immediately preoperatively were identified as risk factors for development of postattenuation neurologic signs (PANS) and PAS .…”

Use of percutaneous transvenous coil embolization in the treatment of intrahepatic portosystemic shunts in four cats

“…1,16 As a result, evaluation of alternative (nonceliotomy-based) treatment options has been performed in dogs with the goals of decreasing the occurrence rate of complications and improving outcomes associated with treatment. [23][24][25] Transvenous coil embolization was first described for small numbers of dogs [26][27][28][29][30] ; more recently, 3 reports [23][24][25] of retrospective and prospective studies have been published that detail outcomes for larger cohorts of dogs. In 1 study, 24 95 dogs with IHPSSs were treated with transvenous embolization, of which 79 (83%) had 1 treatment and 16 (17%) had multiple treatments.…”

“…Significant improvements in clinical signs, liver volume, and hepatic arterial fraction were identified after PTCE. 23 In a third study, 25 cellophane banding was compared with PTCE as treatments for dogs with IHPSSs. The procedural duration between open cellophane banding management in 31 dogs and PTCE in 27 dogs for treatment of IPHSSs did not differ significantly.…”