Anatomic Variations of the Right Portal Vein: Prevalence, Imaging Features, and Implications for Successful Transjugular Intrahepatic Portosystemic Shunt Creation

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Abstract

Given the widespread use of transjugular intrahepatic portosystemic shunt (TIPS) creation for the treatment of portal hypertensive complications, a working knowledge of portal venous anatomy is critical for interventional radiologists. The right portal vein – which is most commonly accessed during TIPS – is subject to various anatomic variants that may potentially impact procedure success. This pictorial essay characterizes the anatomic patterns of the right portal vein branching in terms of type and frequency based on case series review. The work also explains the potential procedural implications of the right portal vein anatomic variations as they pertain to TIPS technical success.

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Most cited references 12

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Insight into congenital absence of the portal vein: is it rare?

Dong-Lai Shen, Guo-Hua Hu, Jin-Fu Yang … (2008)

Congenital absence of portal vein (CAPV) was a rare event in the past. However, the number of detected CAPV cases has increased in recent years because of advances in imaging techniques. Patients with CAPV present with portal hypertension (PH) or portosystemic encephalopathy (PSE), but these conditions rarely occur until the patients grow up or become old. The patients usually visit doctors for the complications of venous shunts, hepatic or cardiac abnormalities detected by ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI). The etiology of this disease is not clear, but most investigators consider that it is associated with abnormal embryologic development of the portal vein. Usually, surgical intervention can relieve the symptoms and prevent occurrence of complications in CAPV patients. Moreover, its management should be stressed on a case-by-case basis, depending on the type or anatomy of the disease, as well as the symptoms and clinical conditions of the patient.

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Incidence, patterns, and clinical relevance of variant portal vein anatomy.

Arthur Brody, Constantinos Sofocleous, Paul A. Covey … (2004)

The purpose of this study was to determine the incidence of variant intrahepatic portal vein anatomy detected on CT portography and to discuss surgical implications. Variant portal vein anatomy is nearly as common as variant hepatic artery anatomy. The complexity of hepatic interventions now performed by interventional radiologists and surgeons, including portal vein embolization, anatomic resection, and transplantation, make recognition and understanding of normal and variant portal vein anatomy increasingly important.

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Developmental basis of the portal venous system.

Natalie Marks (1969)

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Author and article information

Journal

Journal ID (nlm-ta): J Clin Imaging Sci

Journal ID (iso-abbrev): J Clin Imaging Sci

Journal ID (publisher-id): JCIS

Title: Journal of Clinical Imaging Science

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 2156-7514

ISSN (Electronic): 2156-5597

Publication date Collection: 2017

Publication date (Electronic): 28 March 2017

Volume: 7

Electronic Location Identifier: 14

Affiliations

[1]Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, Chicago, IL 60612, USA

Author notes

Address for correspondence: Dr. Ron C Gaba, Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 West Taylor Street, MC 931, Chicago, IL 60612, USA. E-mail: rgaba@ 123456uic.edu

Article

Publisher ID: JCIS-7-14

DOI: 10.4103/jcis.JCIS_10_17

PMC ID: 5385700

PubMed ID: 28515965

SO-VID: a9610e7c-6aad-41d2-acf6-864e48a5dea0

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This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Anatomic Variations of the Right Portal Vein: Prevalence, Imaging Features, and Implications for Successful Transjugular Intrahepatic Portosystemic Shunt Creation

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Abstract

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Probing cerebral hemodynamics with BOLD fMRI

Most cited references 12

Insight into congenital absence of the portal vein: is it rare?

Incidence, patterns, and clinical relevance of variant portal vein anatomy.

Developmental basis of the portal venous system.

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