Percutaneous transsplenic catheterization of the portal venous system

Abstract

Purpose: to evaluate the safety and feasibility of transsplenic portal vein catheterization. Material and Methods: Under ultrasonic guidance, percutaneous transsplenic splenic vein catheterization was performed in 17 patients. Two of the patients had minimal and 5 moderate ascites. in 11 patients, the platelet counts were over 50000/mm3 and the coagulation time normal or mildly prolonged, while 6 patients had either platelet counts of less than 50000/mm3 or moderately prolonged coagulation level. Results: Transsplenic portal catheterizations were successfully performed in 16 of the 17 patients (one failed because of small splenic size). Procedure-related complications occurred in 3 patients with 2 requiring one unit of packed RBC transfusion. the third patient accumulated minimal fluid in the left pleural space. Imaging studies within one week of the procedure were made in 8 patients. These examinations revealed an intrasplenic hematoma in 2 patients. One patient had a small amount of hemoperitone-um. No major complications occurred. Conclusion: Transsplenic portal venous catheterization is a safe and feasible procedure.