Interventional diagnosis and therapy of portal hypertension resulting from hepatic vascular abnormalities

Objective To explore the effect of interventional diagnostic and therapeutic methods for portal hypertension resulting from hepatic vascular abnormalities.Methods Six patients with a history of chronic hepatic disease were firstly diagnosed as cirrhotic portal hypertension.All patients underwent DSA after the abnormalities of portal vein were detected during CT or MRI scan.4 cases of arterioportal malformation and 2 cases of hepatic vein stenosis (Budd-Chiari syndrome) were finally diagnosed by DSA.Hepatic arterial embolization were performed to the arterioportal malformation and hepatic vein balloon angioplasty to the hepatic vein stenoses.Results Therapeutic intervention was successful in all cases.No complication was observed.Hepatic vascular malformation and hepatic vein stenosis disappeared totally or mainly in the post-treatment angiography.The clinical symptoms of portal hypertension improved significantly in short term.A case of extensive arterioportal malformation underwent second arterial embolization and then a TIPS treatment because of portal vein thrombosis.A case of restenosis of hepatic vein occurred 3 years later and the patient received a stent implantation in other hospital.Conclusion Interventional diagnosis and therapy of portal hypertension resulting from hepatic vascular abnormalities are effective and accurate.It should be recommended as a first line choice to treat these diseases.