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Prospective evaluation of outcome of dogs with intrahepatic portosystemic shunts treated via percutaneous transvenous coil embolization
Author(s) -
Culp William T. N.,
Zwingenberger Allison L.,
Giuffrida Michelle A.,
Wisner Erik R.,
Hunt Geraldine B.,
Steffey Michele A.,
Mayhew Philipp D.,
Marks Stanley L.
Publication year - 2018
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/vsu.12732
Subject(s) - medicine , radiology , percutaneous , perfusion , angiography , embolization , scintigraphy , prospective cohort study , clinical significance , portal venous pressure , portal hypertension , nuclear medicine , surgery , cirrhosis
Objective To report outcome and complications after percutaneous transvenous coil embolization (PTCE) and evaluate the clinical, laboratory, and imaging changes in dogs with intrahepatic portosystemic shunts (IHPSS) pre‐PTCE and post‐PTCE. Study design Prospective clinical trial. Animals Twenty‐five dogs (15 dogs in imaging subgroup) with IHPSS. Methods Clinical signs, hematologic, and biochemical parameters were recorded before and 3 months after PTCE. All dogs received the same medical treatment and underwent PTCE. In the imaging subgroup, ultrasonography, hepatic portal scintigraphy, and computed tomography‐angiography were performed pre‐PTCE and post‐PTCE. Results All evaluated bloodwork values improved by at least 50% of their initial value, by 3 months post‐PTCE. Liver volume increased after PTCE ( P = .001), but remained lower than normal in 11/15 dogs. Hepatic arterial fraction decreased after PTCE ( P = .029), consistent with increased portal blood flow to the liver. Twenty‐four of 25 dogs were available for reevaluation at 3 months, and all abnormal clinical signs had resolved in 22/24 dogs. Conclusion PTCE appears promising as a treatment for IHPSS, as clinical signs resolved in most cases, bloodwork abnormalities often normalized, and the procedure was performed safely with minimal complications. PTCE increased hepatic portal perfusion and liver volume in most dogs. These promising results justify a future randomized clinical trial comparing PTCE, other attenuation options, and medical management alone.