Comparison of computed tomographic angiography and intraoperative mesenteric portovenography for extrahepatic portosystemic shunts

Parry, Andrew T. and White, Robert N. (2017) Comparison of computed tomographic angiography and intraoperative mesenteric portovenography for extrahepatic portosystemic shunts. Journal of Small Animal Practice, 58 (1). pp. 49-55. ISSN 1748-5827

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Abstract

Objectives

Comparison of intra-operative mesenteric portovenography and computed tomographic angiography for the documentation of the portal vasculature in patients with single extrahepatic portosystemic shunts.

Methods

Retrospective study of patients with extrahepatic portosystemic shunts that underwent preoperative computed tomographic angiography and intra-operative mesenteric portography. Studies were compared for identification of the intra- and extrahepatic portal vasculature.

Results

Computed tomographic angiography demonstrated all four portal vein tributaries and sub-tributaries. Intra-operative mesenteric portography inconsistently demonstrated the cranial mesenteric vein, the gastroduodenal vein (12 of 49 dogs and 0 of 10 cats), splenic vein (46 of 49 dogs and 8 of 10 cats) and caudal mesenteric vein (3 of 49 dogs and 2 of 10 cats). Computed tomographic angiography showed the intrahepatic portal vein with shunts emanating from the left gastric vein, splenocaval shunts or shunts involving the left colic vein. It showed intrahepatic portal branching in 5 of 12 patients with shunts involving the right gastric vein. Intra-operative mesenteric portography showed the intrahepatic portal vein in 29 of 59 patients but was outperformed by computed tomographic angiography in all cases except those patients with a shunt involving the right gastric vein.

Clinical Significance

In cases that have undergone diagnostic preoperative computed tomographic angiography there is no indication for diagnostic intra-operative mesenteric portovenography before ligation. In contrast, portovenography performed “after” temporary full ligation of the shunt provides clinical useful information and might be considered an integral investigation during shunt attenuation surgery.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: Parry, A.T. and White, R.N. (2017), Comparison of computed tomographic angiography and intraoperative mesenteric portovenography for extrahepatic portosystemic shunts . J Small Anim Pract, 58: 49–55, which has been published in final form at doi:10.1111/jsap.12596. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: Intraoperative mesenteric portovenography, computed tomographic angiography, portosystemic shunt
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Veterinary Medicine and Science
Identification Number: https://doi.org/10.1111/jsap.12596
Depositing User: Eprints, Support
Date Deposited: 07 Feb 2017 14:52
Last Modified: 17 Feb 2017 20:45
URI: http://eprints.nottingham.ac.uk/id/eprint/40399

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