Imaging-guided interventions modulating portal venous flow: Evidence and controversiesKey points
Summary: 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 dise...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | JHEP Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589555922000568 |
| _version_ | 1811241019292778496 |
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| author | Roberto Cannella Lambros Tselikas Fréderic Douane François Cauchy Pierre-Emmanuel Rautou Rafael Duran Maxime Ronot |
| author_facet | Roberto Cannella Lambros Tselikas Fréderic Douane François Cauchy Pierre-Emmanuel Rautou Rafael Duran Maxime Ronot |
| author_sort | Roberto Cannella |
| collection | DOAJ |
| description | Summary: 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. |
| first_indexed | 2024-04-12T13:30:24Z |
| format | Article |
| id | doaj.art-c820750b19ca4ad7b9b84c780378638b |
| institution | Directory Open Access Journal |
| issn | 2589-5559 |
| language | English |
| last_indexed | 2024-04-12T13:30:24Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHEP Reports |
| spelling | doaj.art-c820750b19ca4ad7b9b84c780378638b2022-12-22T03:31:12ZengElsevierJHEP Reports2589-55592022-07-0147100484Imaging-guided interventions modulating portal venous flow: Evidence and controversiesKey pointsRoberto Cannella0Lambros Tselikas1Fréderic Douane2François Cauchy3Pierre-Emmanuel Rautou4Rafael Duran5Maxime Ronot6Université Paris Cité; AP-HP, Hôpital Beaujon, Service de Radiologie, Clichy; Centre de Recherche sur l'inflammation Inserm, UMR 1149, Paris, France; Section of Radiology - Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, Via del Vespro 129, 90127 Palermo, Italy; Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90127 Palermo, ItalyDepartment of Anesthesiology, Surgery and Interventional Radiology, Gustave Roussy, Villejuif, France; Biotheris, CIC 1428 Inserm, Gustave Roussy, Villejuif, France; Université Paris – Saclay, Saint Aubin, FranceService de Radiologie, CHU Nantes, Nantes, FranceUniversité Paris Cité; AP-HP, Hôpital Beaujon, Service de Chirurgie HBP, Clichy, FranceUniversité Paris Cité, AP-HP, Hôpital Beaujon, Service d'Hépatologie, DMU DIGEST, Centre de Référence des Maladies Vasculaires du Foie, FILFOIE, ERN RARE-LIVER, Centre de Recherche sur l'inflammation Inserm, UMR 1149, Paris, FranceDepartment of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, SwitzerlandUniversité Paris Cité; AP-HP, Hôpital Beaujon, Service de Radiologie, Clichy; Centre de Recherche sur l'inflammation Inserm, UMR 1149, Paris, France; Corresponding author. Address: Hopital Beaujon, 100 boulevard du Général Leclerc, 92119 Clichy, France; Tel.: +33 1 40 87 55 66, fax: +33 1 40 87 05 48.Summary: 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.http://www.sciencedirect.com/science/article/pii/S2589555922000568Portal vein interventionsimage guidedtransjugular intrahepatic portosystemic shuntportal vein recanalizationportal vein embolizationportal hypertension |
| spellingShingle | Roberto Cannella Lambros Tselikas Fréderic Douane François Cauchy Pierre-Emmanuel Rautou Rafael Duran Maxime Ronot Imaging-guided interventions modulating portal venous flow: Evidence and controversiesKey points JHEP Reports Portal vein interventions image guided transjugular intrahepatic portosystemic shunt portal vein recanalization portal vein embolization portal hypertension |
| title | Imaging-guided interventions modulating portal venous flow: Evidence and controversiesKey points |
| title_full | Imaging-guided interventions modulating portal venous flow: Evidence and controversiesKey points |
| title_fullStr | Imaging-guided interventions modulating portal venous flow: Evidence and controversiesKey points |
| title_full_unstemmed | Imaging-guided interventions modulating portal venous flow: Evidence and controversiesKey points |
| title_short | Imaging-guided interventions modulating portal venous flow: Evidence and controversiesKey points |
| title_sort | imaging guided interventions modulating portal venous flow evidence and controversieskey points |
| topic | Portal vein interventions image guided transjugular intrahepatic portosystemic shunt portal vein recanalization portal vein embolization portal hypertension |
| url | http://www.sciencedirect.com/science/article/pii/S2589555922000568 |
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