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Intrahepatic arterioportal fistulae: Role of transcatheter embolization

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Abstract

Management of 26 arterioportal fistulae (APFs) is reported. Among 13 hepatoma-induced fistulae (group A), conservative treatment was inefective in 8 patients, and arterial embolization alleviated portal hypertension in the other 5. Of 10 iatrogenic APFs (group B), the 3 largest were successfully embolized, the remaining lesions resolved spontaneously. Three spontaneous nonmalignant APFs (group C) were embolized. Excellent results were obtained in 2 patients, and the other died of severe postembolization hepatic failure. Because long-standing APFs may cause severe portal hypertension with consequent variceal bleeding they should be treated. Arterial embolization is indicated in most patients.

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References

  1. Morse SS, Sniderman KW, Galloway S, Rappoport S, Ross GR, Glickman MG (1985) Hepatoma, arterioportal shunting and hyperkinetic portal hypertension: Therapeutic embolization. Radiology 155:77–82

    PubMed  CAS  Google Scholar 

  2. Strodel WE, Eckhauser FE, Lemmer JH, Whitehouse WM, Williams DM (1987) Presentation and perioperative management of arterioportal fistulas. Arch. Surg 122:563–571

    PubMed  CAS  Google Scholar 

  3. Van Way CW, Grabe JM, Riddell DH, Foster JH (1971) Arteriovenous fistula in the portal circulation. Surgery 70:876–890

    PubMed  Google Scholar 

  4. Nagasue N, Inokuchi K, Kobayashi M, Saku M (1977) Hepatoportal arteriovenous fistula in primary carcinoma of the liver. Surg Gynecol Obstet 145:504–508

    PubMed  CAS  Google Scholar 

  5. Borisova NA, Ryzhkov VK, Borisov AE, Gapchenko EM (1989) Arterioportale Fisteln als Folge einer percutanen transhepatischen Katheterisierung der Vena portae. Radiol Diagn (Berl) 30:165–170

    CAS  Google Scholar 

  6. Keller FS, Rösch J (1985) Percutaneous management of iatrogenic arterial venous fistulas by coil spring occlusion. Eur J Radiol 5:202–205

    PubMed  CAS  Google Scholar 

  7. Itzchak Y, Adar R, Bogokowski H, Mozes M, Deutsch V (1974) Intrahepatic arterial portal communications: Angiographic study. AJR 121:384–387

    CAS  Google Scholar 

  8. Winograd J, Palubinskas AJ (1977) Arterio-portal venous shunting in cavernous hemangioma of the liver. Radiology 122:331–332

    PubMed  CAS  Google Scholar 

  9. Applbaum YN, Renner JW (1987) Steel coil embolization of hepatoportal fistulae. Cardiovasc Intervent Radiol 10:75–79

    Article  PubMed  CAS  Google Scholar 

  10. Tisnado J, Bezirdjian DR (1990) Transcatheter therapy of iatrogenic vascular injuries to the liver. Semin Intervent Radiol 7:263–274

    Google Scholar 

  11. Okuda K, Obata H, Nakajima Y, Ohtsuki T, Okazaki N, Ohnishi K (1984) Prognosis of primary hepatocellular carcinoma. Hepatology 4 (Suppl):3S-6S

    Article  PubMed  CAS  Google Scholar 

  12. Ryzhkov VK, Borisova NA, Gapchenko EM, Dmitrijeva IA (1988) Verschluß von Arterien durch vergrößerte Spiralembolisate. Radiol Diagn (Berl) 29:713–717

    Google Scholar 

  13. Lunderquist A, Vang J (1974) Transhepatic catheterization and obliteration of the coronary vein in patients with portal hypertension and esophageal varices. New Engl J Med 291:646–649

    Article  PubMed  CAS  Google Scholar 

  14. Mays ET (1977) Vascular occlusion. Surg Clin North Am 57:291–323

    PubMed  CAS  Google Scholar 

  15. Savastano S, Feltrin GP, Miotto D, Chiesura-Corona M, Rubaltelli L, Candiani F (1989) Vascular parenchymal sources of upper gastrointestinal bleeding. Acta Radiologica 30:39–43

    Article  PubMed  CAS  Google Scholar 

  16. Kerlan RK, Bank WO, Hoddik WK, Pogany AC, Sollenberger RD (1983) Occlusion of a hepatic artery to portal vein fistula with Bucrylate. Cardiovasc Intervent Radiol 6:138–140

    Article  PubMed  Google Scholar 

  17. Mallarini G, Saitta S, Cariati M, Nicorelli M, DeCaro G (1982) Embolization of AV intrahepatic fistulas. Eur J Radiol 2:152–156

    PubMed  CAS  Google Scholar 

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Tarazov, P.G. Intrahepatic arterioportal fistulae: Role of transcatheter embolization. Cardiovasc Intervent Radiol 16, 368–373 (1993). https://doi.org/10.1007/BF02603142

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