%0 Journal Article
%T Clinical outcomes of symptomatic arterioportal fistulas after transcatheter arterial embolization
%A Masakazu Hirakawa
%A Akihiro Nishie
%A Yoshiki Asayama
%A Kousei Ishigami
%J World Journal of Radiology
%D 2013
%I Baishideng Publishing Group Co. Limited
%R 10.4329/wjr.v5.i2.33
%X AIM: To evaluate the complications and clinical outcomes of transcatheter arterial embolization (TAE) for symptoms related to severe arterioportal fistulas (APFs). METHODS: Six patients (3 males, 3 females; mean age, 63.8 years; age range, 60-71 years) with chronic liver disease and severe APFs due to percutaneous intrahepatic treatment (n = 5) and portal vein (PV) tumor thrombosis of hepatocellular carcinoma (n = 1) underwent TAE for symptoms related to severe APFs [refractory ascites (n = 4), hemorrhoidal hemorrhage (n = 1), and hepatic encephalopathy (n = 1)]. Control of symptoms related to APFs and complications were evaluated during the follow-up period (range, 4-57 mo). RESULTS: In all patients, celiac angiography revealed immediate retrograde visualization of the main PV before TAE, indicating severe APF. Selective TAE for the hepatic arteries was performed using metallic coils (MC, n = 4) and both MCs and n-butyl cyanoacrylate (n = 2). Three patients underwent repeated TAEs for residual APFs and ascites. Four patients developed PV thrombosis after TAE. During the follow-up period after TAE, APF obliteration and symptomatic improvement were obtained in all patients. CONCLUSION: Although TAE for severe APFs may sometimes be complicated by PV thrombosis, TAE can be an effective treatment to improve clinical symptoms related to severe APFs.
%K Arterioportal fistula
%K Iatrogenic
%K Portal hypertension
%K Portal thrombosis
%K Transcatheter arterial embolization
%U http://www.wjgnet.com/1949-8470/full/v5/i2/33.htm