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Khoronko Yu.V.

Rostov State Medical University

Sapronova N.G.

Rostov State Medical University

Kosovtsev E.V.

Rostov State Medical University

Khoronko E.Yu.

Rostov State Medical University

Abdullaev K.I.

Rostov State Medical University

Ashimov I.A.

Rostov State Medical University

Surgeon’s view: portal vein system’s vessels angioarchitecture in portal hypertension

Authors:

Khoronko Yu.V., Sapronova N.G., Kosovtsev E.V., Khoronko E.Yu., Abdullaev K.I., Ashimov I.A.

More about the authors

Journal: Russian Journal of Operative Surgery and Clinical Anatomy. 2023;7(2): 37‑45

DOI: 10.17116/operhirurg2023702137

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Table of contents

SURGEON’S VIEW: PORTAL VEIN SYSTEM’S VESSELS ANGIOARCHITECTURE IN PORTAL HYPERTENSION
SURGEON’S VIEW: PORTAL VEIN SYSTEM’S VESSELS ANGIOARCHITECTURE IN PORTAL HYPERTENSION

To cite this article:

Khoronko YuV, Sapronova NG, Kosovtsev EV, Khoronko EYu, Abdullaev KI, Ashimov IA. Surgeon’s view: portal vein system’s vessels angioarchitecture in portal hypertension. Russian Journal of Operative Surgery and Clinical Anatomy. 2023;7(2):37‑45. (In Russ.)
https://doi.org/10.17116/operhirurg2023702137

Подписка 2025-2 (Russian Journal of Operative Surgery and Clinical Anatomy)
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OBJECTIVE

To study the angioarchitecture of the inflow tracts of portal blood to esophageal and gastric varices in portal hypertension. Estimation of feasibility and laboriousness assessment of their selective endovascular embolization to control of variceal bleeding.

MATERIAL AND METHODS

Series of phlebo-portograms performed at the stage of direct portography during transjugular intrahepatic portosystemic shunting (TIPS) in 202 patients with cirrhotic portal hypertension were analyzed. The angioarchitecture of the inflow tracts to the esophageal and gastric varices (left, posterior and short gastric veins) was studied. The details of their branching after selective catheterization with subsequent contrast enhancement have also been studied.

RESULTS

The anatomical features of the tributaries of portal and splenic veins involved in the formation of varicose esophagogastric transformation in patients with bleeding caused by portal hypertension were analyzed. The responsibility of the left, posterior and short gastric veins for the formation of varices was established in 100%, 67.5% and 16.2% of patients, respectively. Their course is characterized by extensive branching and anastomosing in variceal zone. These facts demand to perform selective embolization of all identified inflow tracts to the varices.

CONCLUSION

The features of angioarchitecture of inflow tracts to esophagogastric varices in patients with variceal bleeding caused by portal hypertension were analyzed. The responsibility of the left, posterior and short gastric veins for the formation of nodes was established in 100%, 67.5% and 16.2% of patients, respectively. It course is characterized by extensive branching and anastomosing in variceal zone. The established facts demand to perform selective embolization of all identified inflow tracts to the varices.

Keywords:

esophagogastric varices
left and posterior gastric veins
angioarchitectonics of portal vein’s system
portal hypertension

Authors:

Khoronko Yu.V.

Rostov State Medical University

Sapronova N.G.

Rostov State Medical University

Kosovtsev E.V.

Rostov State Medical University

Khoronko E.Yu.

Rostov State Medical University

Abdullaev K.I.

Rostov State Medical University

Ashimov I.A.

Rostov State Medical University

Received:

14.12.2022

Accepted:

21.01.2023

List of references:

  1. Zanetto A, Shalaby S, Feltracco P, Gambato M, Germani G, Russo FP, Burra P, Senzolo M. Recent Advances in the Management of Acute Variceal Hemorrhage. J Clin Med. 2021;10(17):3818. Published online 2021 Aug 25.  https://doi.org/10.3390/jcm10173818
  2. Angeli P, Bernardi M, Villanueva C, Francoz C, Mookerjee RP, Trebicka J, Krag A, Laleman W, Gines P. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018;69(2):406-460.  https://doi.org/10.1016/j.jhep.2018.03.024
  3. Khan F, Tripathi D. Role of early transjugular intrahepatic portosystemic stent-shunt in acute variceal bleeding: An update of the evidence and future directions. World J Gastroenterol. 2021;27(44):7612-7624. https://doi.org/10.3748/wjg.v27.i44.7612
  4. Roberts D, Best LMJ, Freeman SC, Sutton AJ, Cooper NJ, Arunan S, Begum T, Williams NR, Walshaw D, Milne EJ, Tapp M, Csenar M, Pavlov CS, Davidson BR, Tsochatzis E, Gurusamy KS. Treatment for bleeding oesophageal varices in people with decompensated liver cirrhosis: a network meta-analysis. Cochrane Database Syst Rev. 2021;2021(4):CD013155. https://doi.org/10.1002/14651858.CD013155.pub2
  5. Yao Q, Chen W, Yan C, Yu J, Jiang T, Cao H. Efficacy and Safety of Treatment for Patients With Portal Hypertension and Cirrhosis: A Systematic Review and Bayesian Network Meta-Analysis. Front Med (Lausanne). 2021;8:712918. Published online 2021 Sep 3.  https://doi.org/10.3389/fmed.2021.712918
  6. Nagashima K, Irisawa A, Tominaga K, Kashima K, Kunogi Y, Minaguchi T, Izawa N, Yamamiya A, Yamabe A, Hoshi K, Goda K, Iijima M. The Role of Endoscopic Ultrasound for Esophageal Varices. Diagnostisc (Basel). 2020;10(12):1007. Published online 2020 Nov 25.  https://doi.org/10.3390/diagnostics10121007
  7. de Franchis R, Bosch J, Garcia-Tsao G, Reinberger T, Ripoli C, Baveno VII Faculty. Baveno VII — Renewing consensus in portal hypertension. J Hepatol. 2022;76(4):959-974.  https://doi.org/10.1016/j.jhep.2021.12.022
  8. Nardelli S, Riggio O, Gioia S, Puzzono M, Pelle G, Ridola L. Spontaneous portosystemic shunts in liver cirrhosis: Clinical and therapeutical aspects. World J Gastroenterol. 2020;26(15):1726-1732. https://doi.org/10.3748/wjg.v26.i15.1726
  9. Vidal-González J, Quiroga S, Simon-Talero M, Genescà J. Spontaneous portosystemic shunts in liver cirrhosis: new approaches to an old problem. Ther Adv Gastroenterol. 2020;13:1756284820961287. Published online 2020 Sep 29.  https://doi.org/10.1177/1756284820961287
  10. Yi F, Guo X, Zeng QL, Yang B, He B, Yuan S, Arora A, Qi X. Computed Tomography Images of Spontaneous Portosystemic Shunt in Liver Cirrhosis. Can J Gastroenterol Hepatol. 2022;2022:3231144. eCollection. https://doi.org/10.1155/2022/3231144
  11. Bibalaev MH, Dydykin SS, Scherbyuk AN. Surgical treatment of complications of portal hypertension using splenorenal anastomosis. Vestnik khirurgii im. I.I. Grekova. 2018;177(1):100-103. (In Russ.). https://doi.org/10.24884/0042-4625-2018-177-1-100-103
  12. Nazyrov FG, Devyatov AV, Babadjanov AKh, Makhmudov UM, Omonov OA. Efficacy of different methods for preventing gastroesophageal bleeding in patients with liver cirrhosis: comparative analysis. Annaly khirurgicheskoy gepatologii. 2022;27(2):31-38. (In Russ.). https://doi.org/10.16931/1995-5464.2022-2-31-38
  13. Fehrenbach U, Gül-Klein S, de Sousa Mendes M, Steffen I, Stern J, Geisel D, Puhl G, Denecke T. Portosystemic shunt surgery in the era of TIPS: imaging-based planning of the surgical approach. Abdom Radiol (NY). 2020;45(9):2726-2735. https://doi.org/10.1007/s00261-020-02599-z
  14. Efimov DYu, Fedoruk DA, Nosik AE, Kirkovski LV, Kozak ON, Avdei EL, Savchenko AV, Korotkov SV, Shcherba AE, Rummo OO. Evolution of approaches to portal hypertension syndrome and principles underlying treatment personalization. Annaly khirurgicheskoy. 2022;27(2):39-47. (In Russ.). https://doi.org/10.16931/1995-5464.2022-2-39-47
  15. Radu P, Prunoiu VM, Strâmbu V, Garofil D, Doncu RE, Bratucu E, Simion L, Ravas MM, Bratucu MN. The Portosystemic Shunt for the Control of Variceal Bleeding in Cirrhotic Patients: Past and Present. Can J Gastroenterol Hepatol. 2022;2022:1382556. Published online 2022 Sep 17.  https://doi.org/10.1155/2022/1382556
  16. Lebezev VM, Manukyan GV, Fandeev EE, Kitsenko EA, Musin RA, Kosakevich EA, Rizaeva SA, Bobyleva YS. «Left gastric vein to inferior vena cava» bypass in patients with portal hypertension. Annaly khirurgicheskoy gepatologii. 2020;25(1):27-37. (In Russ.). https://doi.org/10.16931/1995-5464.2020127-37
  17. Boike JR, Thomburg BG, Asrani SK, Fallon MB, Fortune BE, Izzy MJ, Verna EC, Abraldes JG, Allegretti AS, Bajaj JS, Biggins SW, Darcy MD, Farr MA, Farsad JS, Garcia-Tsao G, Hall SA, Jadlowiec CC. North American Practice-Based Recommendations for Transjugular Intrahepatic Portosystemic Shunts in Portal Hypertension. Clin Gastroenterol Hepatol. 2022;20(8):1636-1662. e36.  https://doi.org/10.1016/j.cgh.2021.07.018
  18. Büttner L, Aigner A, Pick L, Brittinger J, Stelb CJ, Böning G, Steitparth F. 25 years of experience with transjugular intrahepatic portosystemic shunt (TIPS): changes in patient selection and procedural aspects. Insights Imaging. 2022;13(1):73.  https://doi.org/10.1186/s13244-022-01216-5
  19. Manning C, Elzubeir A, Alam S. The role of pre-emptive Transjugular Intrahepatic Portosystemic Shunt in acute variceal bleeding: A literature review. Ther Adv Chronic Dis. 2021;12:2040622321995771. Published online 2021 Mar 5.  https://doi.org/10.1177/2040622321995771
  20. Gaba RC. Transjugular Intrahepatic Portosystemic Shunt Creation With Embolization or Obliteration for Variceal Bleeding. Tech Vasc Interv Radiol. 2016;19(1):21-35.  https://doi.org/10.1053/j.tvir.2016.01.003
  21. Zhou L, Zhong B, Du H, Wang W, Shen J, Zhang S, Li W, Tang H, Zhang P, Yang W, Zhu X. Comparison of embolic agents for varices during transjugular intrahepatic portosystemic shunt for variceal bleeding: Tissue gel or coil? J Interv Med. 2020;3(4):195-200.  https://doi.org/10.1016/j.jimed.2020.08.008
  22. Ishikawa T. Efficacy of interventional radiology in the management of portal hypertension: A narrative review. Medicine (Baltimore). 2022;101(33):e30018. Published online 2022 Aug 19.  https://doi.org/10.1097/MD.0000000000030018
  23. Lv Y, Chen H, Luo B, Bai W, Li K, Wang Z, Xia D, Guo W, Wang Q, Li X, Yuan J, Cai H, Xia J,Yin Z, Fan D, Han G. Transjugular intrahepatic portosystemic shunt with or without gastro-oesophageal variceal embolisation for the prevention of variceal rebleeding: a randomized controlled trial. Lancet Gastroenterol Hepatol. 2022;7(8):736-746.  https://doi.org/10.1016/S2468-1253(22)00087-5
  24. Kovalenko NA, Gaivoronskiy IV, Kotiv BN, Bahovadinova ShB, Kantemirov VV, Novickaja NJu. Clinical significance of variant anatomy of the left gastric vein. MEDLINE.RU. Rossiyskiy biomeditsinskiy zhurnal. 2018;19:103-116 (in Russ.).
  25. Sarin SK, Lahoti D, Saxena SP, Murthy NS, Makwana UK. Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients. Hepatology. 1992;16(6):1343-1349. https://doi.org/10.1002/hep.1840160607
  26. Kimura K, Ohto M, Matsutani S, Furuse J, Hoshino K, Okuda K. Relative frequencies of portosystemic pathways and renal shunt formation through the «posterior» gastric vein: portographic study in 460 patients. Hepatology. 1990;12(4):725-728.  https://doi.org/10.1002/hep.1840120417
  27. Dydykin SS, Zadnipryanyi IV, Tretyakova OS. AQUA (anatomical quality assurance): A review of the experience of foreign colleagues. Operativnaya khirurgiya I klinicheskaya anatomoya (Pirogovskii nauchnyi zhurnal). 2017;1:14-19. (In Russ.). https://doi.org/10.17116/operhirurg20171114-19
  28. Kolsanov AV, Miakotnykh MN, Mironov AA, Yunusov RR. 3D anatomy of the intrahepatic branches of the portal vein according to the computer tomography. Operativnaya khirurgiya I klinicheskaya anatomoya (Pirogovskii nauchnyi zhurnal). 2020;4(4):16-21. (In Russ.). https://doi.org/10.17116/operhirurg2020404116

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