Double-Balloon-Assisted N-Butyl-2-Cyanoacrylate Embolization of Nontumorous Intrahepatic Arterioportal Shunts

J Vasc Interv Radiol. 2019 Aug;30(8):1210-1214.e2. doi: 10.1016/j.jvir.2019.04.011. Epub 2019 Jun 27.

Abstract

This report describes the safety and efficacy of double-balloon-assisted N-butyl-2-cyanoacrylate embolization of nontumorous intrahepatic arterioportal shunts in 5 consecutive, previously untreated patients. A proximal balloon was used for flow control and a coaxial microballoon was used to control the delivery of N-butyl-2-cyanoacrylate. Complete occlusion was achieved in 3 patients and shunt flow decreased in 2 patients, without complications. In the latter 2 patients, pre-embolization shunt flow was lower than that in patients with complete occlusion. Our results suggest that this coaxial double-balloon-assisted technique may be safe and effective for the embolization of nontumorous intrahepatic arterioportal shunts, especially in high-flow shunts.

MeSH terms

  • Aged
  • Balloon Occlusion / adverse effects
  • Balloon Occlusion / methods*
  • Blood Flow Velocity
  • Collateral Circulation
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Enbucrilate / administration & dosage*
  • Enbucrilate / adverse effects
  • Female
  • Hepatic Artery / diagnostic imaging
  • Hepatic Artery / physiopathology*
  • Humans
  • Liver Circulation*
  • Male
  • Middle Aged
  • Portal Vein / diagnostic imaging
  • Portal Vein / physiopathology*
  • Radiography, Interventional
  • Treatment Outcome
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / physiopathology
  • Vascular Diseases / therapy*

Substances

  • Enbucrilate