Imaging-guided interventions modulating portal venous flow: Evidence and controversies
| Autor: | Roberto Cannella, Lambros Tselikas, Fréderic Douane, François Cauchy, Pierre-Emmanuel Rautou, Rafael Duran, Maxime Ronot |
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| Přispěvatelé: | Cannella R., Tselikas L., Douane F., Cauchy F., Rautou P.E., Duran R., Ronot M. |
| Rok vydání: | 2022 |
| Předmět: |
Hepatology
Gastroenterology Internal Medicine Immunology and Allergy ALPPS associating liver partition and portal vein ligation for staged hepatectomy transjugular intrahepatic portosystemic shunt BSG British Society of Gastroenterology EASL European Association for the Study of the Liver FLR future liver remnant HE hepatic encephalopathy NCBA N-butyl cyanoacrylate PH portal hypertension PVE portal vein embolisation PVR portal vein recanalisation TIPS transjugular intrahepatic portosystemic shunt Portal vein interventions TACE trans-arterial chemoembolization portal vein recanalization RCT randomised controlled trial portal vein embolization portal hypertension image guided |
| Zdroj: | JHEP Reports. 4:100484 |
| ISSN: | 2589-5559 |
| DOI: | 10.1016/j.jhepr.2022.100484 |
| Popis: | Portal hypertension is defined by an increase in the portosystemic venous gradient. In most cases, increased resistance to portal blood flow is the initial cause of elevated portal pressure. More than 90% of cases of portal hypertension are estimated to be due to advanced chronic liver disease or cirrhosis. Transjugular intrahepatic portosystemic shunts, a non-pharmacological treatment for portal hypertension, involve the placement of a stent between the portal vein and the hepatic vein or inferior vena cava which helps bypass hepatic resistance. Portal hypertension may also be a result of extrahepatic portal vein thrombosis or compression. In these cases, percutaneous portal vein recanalisation restores portal trunk patency, thus preventing portal hypertension-related complications. Any portal blood flow impairment leads to progressive parenchymal atrophy and triggers hepatic regeneration in preserved areas. This provides the rationale for using portal vein embolisation to modulate hepatic volume in preparation for extended hepatic resection. The aim of this paper is to provide a comprehensive evidence-based review of the rationale for, and outcomes associated with, the main imaging-guided interventions targeting the portal vein, as well as to discuss the main controversies around such approaches. (c) 2022 The Authors. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/). |
| Databáze: | OpenAIRE |
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