Inferior mesenteric veno-caval shunt: imaging features and interventional treatment

Matsumoto, S.; Mori, H.; Sagara, Y.; Kiyosue, H.; Tanoue, S.

doi:10.1016/j.crad.2006.11.014

« Previous Next »Clinical Radiology
Volume 62, Issue 4 , Pages 358-364, April 2007

Inferior mesenteric veno-caval shunt: imaging features and interventional treatment

Oita University Faculty of Medicine, Department of Radiology, Oita, Japan

Received 15 May 2006; received in revised form 26 October 2006; accepted 1 November 2006.

Aim

To describe the imaging features of inferior mesenteric vein (IMV)–inferior vena cava (IVC) shunts, and to describe a treatment strategy for portosystemic encephalopathy, which can be caused by them.

Materials and methods

Between 2000 and 2004, we treated seven patients who had symptomatic IMV–IVC shunts. The results of imaging investigations, which included contrast-enhanced computed tomography (CT), angiography, and CT during arterial portography, were reviewed retrospectively. We also present our results in the four patients who were treated by retrograde transcaval obliteration (RTCO).

Results

The IMV–IVC shunts had a tortuous or cirsoid appearance ranging in size from 7.2–14.6mm. The shunts were located at a level near to the first branch of the inferior mesenteric artery. The four patients were successfully treated by RTCO and their clinical symptoms improved.

Conclusion

IMV–IVC shunts show a tortuous or cirsoid appearance, connecting at or near the first branch of the inferior mesenteric artery. For symptomatic IMV–IVC shunts, RTCO is recommended as the first choice treatment.