Ultrasound- and fluoroscopy-guided percutaneous transhepatic shunt attenuation using a vascular plug in a complex canine intrahepatic portosystemic shunt.
Kornelia TiffingerJustin B SmithBoel A FranssonPublished in: The Canadian veterinary journal = La revue veterinaire canadienne (2024)
A 5-month-old Pembroke Welsh corgi dog was presented with a 3-month history of lethargy, inappetence, polyuria/polydipsia, and neurological signs. A diagnosis of a complex multiple intrahepatic portosystemic shunt (IHPSS) configuration was obtained by computed tomography angiogram, abdominal ultrasonography, and perioperative fluoroscopic angiography. The IHPSS was successfully attenuated by shunt embolization with a vascular plug, using a direct percutaneous hepatic approach under ultrasonographic and fluoroscopic guidance. Long-term (4 y) follow-up revealed resolution of all clinical signs. The owner elected to continue dietary modification and lactulose treatment indefinitely and the outcome was considered good. Key clinical message: Direct percutaneous hepatic approach could be considered for IHPSS attenuation in select cases where traditional transvenous approach access is considered challenging.
Keyphrases
- computed tomography
- pulmonary artery
- ultrasound guided
- magnetic resonance imaging
- minimally invasive
- radiofrequency ablation
- contrast enhanced
- optical coherence tomography
- positron emission tomography
- pulmonary hypertension
- patients undergoing
- pulmonary arterial hypertension
- single cell
- atrial fibrillation
- magnetic resonance
- blood brain barrier
- combination therapy