Portal vein embolization for closure of marked arterioportal shunt of hepatocellular carcinoma to enable radioembolization:A case report  

作　　者：Xiang-Dong Wang Nai-Jian Ge Ye-Fa Yang 

机构地区：[1]Department of Interventional Radiology,Shanghai Eastern Hepatobiliary Surgery Hospital,Shanghai 200438,China

出　　处：《World Journal of Gastrointestinal Surgery》2023年第12期2926-2931,共6页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Marked arterioportal shunt(APS)can be a contraindication for transarterial radioembolization(TARE)because of the risk of radiation-induced liver toxicity or pneumonitis.To date,the best method to close marked APS to reduce intrahepatic shunt(IHS)and hepatopulmonary shunt(HPS)before TARE has not been elucidated.CASE SUMMARY This case report describes a novel strategy of embolization of the portal venous outlet to reduce IHS and HPS caused by marked APS before TARE in a patient with advanced hepatocellular carcinoma(HCC).The patient had a significant intratumoral shunt from the tumor artery to the portal vein and had already been suspected based on pre-interventional magnetic resonance angiography,and digital subtraction angiography(DSA)confirmed the shunt.Selective right portal vein embolization(PVE)was performed to close the APS outlet and DSA confirmed complete closure.Technetium-99m macroaggregated albumin was administered and single photon emission computed tomography revealed a low HPS with 8.4%.Successful TARE was subsequently performed.No major procedurerelated complication occurred.CONCLUSION Closure of APS with PVE during mapping angiography of advanced-stage HCC to enable reduction of HPS and subsequent TARE is feasible.

关 键 词：Portal vein embolization Arterioportal shunt Intrahepatic shunt Hepatopulmonary shunt Transarterial radioembolization Case report 

分 类 号：R735.7[医药卫生—肿瘤]