Imaging-guided interventions modulating portal venous flow: Evidence and controversies.

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UNIL restricted access
State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_F0B8B023631B
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Imaging-guided interventions modulating portal venous flow: Evidence and controversies.
Journal
JHEP reports
Author(s)
Cannella R., Tselikas L., Douane F., Cauchy F., Rautou P.E., Duran R., Ronot M.
ISSN
2589-5559 (Electronic)
ISSN-L
2589-5559
Publication state
Published
Issued date
07/2022
Peer-reviewed
Oui
Volume
4
Number
7
Pages
100484
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
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.
Keywords
ALPPS, associating liver partition and portal vein ligation for staged hepatectomy, 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, Portal vein interventions, RCT, randomised controlled trial, TACE, trans-arterial chemoembolization, TIPS, transjugular intrahepatic portosystemic shunt, image guided, portal hypertension, portal vein embolization, portal vein recanalization, transjugular intrahepatic portosystemic shunt
Pubmed
Open Access
Yes
Create date
21/06/2022 14:16
Last modification date
21/07/2022 6:37
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