Portal Vein Thrombosis after Endovascular Embolization of Splenic Artery for a Symptomatic Arterioportal Fistula: A Case Report and Literature Review

Ann Vasc Surg. 2018 Nov:53:270.e7-270.e12. doi: 10.1016/j.avsg.2018.05.075. Epub 2018 Aug 6.

Abstract

Arterioportal fistula (APF) can induce severe portal hypertension and therefore requires appropriate and timely management. Endovascular treatment is increasingly used for the treatment of APFs due to its minimally invasive nature, although this procedure can lead to potentially fatal portal vein thrombosis (PVT). Reports of this complication are, however, rare. Here, we describe the case of a 65-year-old woman who experienced an extensive thrombosis from the splenic vein to the right portal vein after embolization of a splenic APF, leading to the requirement for intensive care unit care and a prolonged hospital stay. In addition, the literature was reviewed to describe the clinical manifestations, diagnosis, and treatment of PVT after embolization of APF.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Angiography, Digital Subtraction
  • Arteriovenous Fistula / diagnostic imaging
  • Arteriovenous Fistula / physiopathology
  • Arteriovenous Fistula / therapy*
  • Computed Tomography Angiography
  • Embolization, Therapeutic / adverse effects*
  • Endovascular Procedures / adverse effects*
  • Female
  • Humans
  • Phlebography / methods
  • Portal Vein* / diagnostic imaging
  • Portal Vein* / physiopathology
  • Splenic Artery* / diagnostic imaging
  • Splenic Artery* / physiopathology
  • Splenic Vein* / diagnostic imaging
  • Splenic Vein* / physiopathology
  • Treatment Outcome
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / etiology*
  • Venous Thrombosis / physiopathology
  • Venous Thrombosis / therapy