Spontaneous intrahepatic portal-systemic shunts are rare and can lead to significant encephalopathy. If intervention is recommended, transcatheter embolization is preferred. Various embolization techniques have been described using a wide range of embolization materials. In this report, the authors describe a useful embolization technique for managing a complex, large type 3 spontaneous intrahepatic portal-systemic shunt using Nester coils and Amplatzer vascular plugs through both percutaneous systemic and transhepatic approaches.
TanoueSKiyosueHKomatsuEHoriYMaedaTMoriH. Symptomatic intrahepatic portosystemic venous shunt: embolization with an alternative approach. AJR Am J Roentgenol. 2003;181:71-78.
WittersPMaleuxGGeorgeC. Congenital veno-venous malformations of the liver: widely variable clinical presentations. J Gastroenterol Hepatol. 2008;23(8 pt 2): e390-e394.
7.
YoshimatsuRTakeuchiYMorishitaH. Successful embolisation of intrahepatic portosystemic venous shunt using coils and n-butyl cyanoacrylate through two approach routes. Br J Radiol. 2006;79:e162-e165.
8.
YamagamiTNakamuraTIidaS. Hepatic encephalopathy secondary to intrahepatic portosystemic venous shunt: balloon-occluded retrograde transvenous embolization with n-butyl cyanoacrylate and microcoils. Cardiovasc Intervent Radiol. 2002;25:219-221.
