Matsuoka S, Yamana Y, Ishii T, Kumagawa M, Mizutani T, Kamimura S, Matsumoto N, Nakamura H, Nirei K, Tatsuo K, Moriyama M. Portal-systemic Encephalopathy due to Complicated Spleno-renal Shunt Successfully Treated with Balloon-occluded Retrograde Transvenous Obliteration Using a Double Coaxial Balloon Catheter System and Shape-memory Coils.
Intern Med 2018;
57:1861-1866. [PMID:
29491295 PMCID:
PMC6064694 DOI:
10.2169/internalmedicine.0247-17]
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Abstract
A 70-year-old woman with hepatitis C cirrhosis underwent balloon-occluded retrograde transvenous obliteration for hepatic encephalopathy due to spleno-renal shunt. Because the shunt was thick, long, and winding, we used a coaxial and double interruption system, which enables the effective occlusion of the drainage route, and shape-memory coils, which are more physically stable than conventional metallic coils because they form three-dimensional loops. The patient was successfully treated with the combined usage of these devices, resulting in a normal serum ammonia level. Thereafter, the patient was treated with direct-acting antivirals, and a sustained virological response was achieved.
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