Imaging-guided interventions modulating portal venous flow: Evidence and controversies.
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
Journal
JHEP reports : innovation in hepatology
ISSN: 2589-5559
Titre abrégé: JHEP Rep
Pays: Netherlands
ID NLM: 101761237
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
received:
30
11
2021
revised:
23
03
2022
accepted:
25
03
2022
entrez:
9
6
2022
pubmed:
10
6
2022
medline:
10
6
2022
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 35677591
doi: 10.1016/j.jhepr.2022.100484
pii: S2589-5559(22)00056-8
pmc: PMC9168703
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
100484Informations de copyright
© 2022 The Authors.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest that pertain to this work. Please refer to the accompanying ICMJE disclosure forms for further details.
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