Preloading Coil in Plug Method (p-CIP) with the AVP 2 for large Portosystemic Shunt Embolization

Kazuki Hashimoto; Yukihisa Ogawa; Shinji Wada; Daichi Kobayashi; Shingo Hamaguchi; Junji Moriya; Hidefumi Mimura

doi:10.1016/j.radcr.2021.06.075

Preloading Coil in Plug Method (p-CIP) with the AVP 2 for large Portosystemic Shunt Embolization

Radiol Case Rep. 2021 Aug 1;16(10):2899-2903. doi: 10.1016/j.radcr.2021.06.075. eCollection 2021 Oct.

Authors

Kazuki Hashimoto¹, Yukihisa Ogawa¹, Shinji Wada¹, Daichi Kobayashi¹, Shingo Hamaguchi¹, Junji Moriya¹, Hidefumi Mimura¹

Affiliation

¹ Department of Radiology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan.

Abstract

Hepatic encephalopathy caused by a large portosystemic shunt (PSS) can be treated by endovascular embolization of the shunt. The PSS diameter can be >20 mm; it occasionally poses technical difficulties. Here, a 72-year-old woman with liver cirrhosis, hyperammonemia, and large spleno-renal shunt underwent shunt embolization using an Amplatzer vascular plug 2 (AVP2) and metallic coils. The preloading coil in plug method (p-CIP), which facilitated embolization inside the AVP2 without cannulation from outside, was employed to overcome technical difficulties. We propose the use of p-CIP with an AVP2 as a tool for treatment of hepatic encephalopathy with PSS.

Keywords: AVP; Embolization; Hepatic encephalopathy; Portosystemic shunt; Preloading coil-in-plug method (p-CIP).

Publication types

Case Reports