Transsplenic Access for Portal Venous Interventions

Purpose: The purpose of this study is to report our experience with transsplenic access for portal venous interventions in both children and adults.

Materials and Methods: Under ultrasonic guidance, percutaneous transsplenic splenic vein catheterization was performed in five patients. One of the patients, who was a child, had trace ascites, and 2 adults had moderate ascites. In all the patients, the platelet counts were over 50000/mm³, and the coagulation time was normal or mildly prolonged.

Results: Transsplenic portal catheterizations were successfully performed in all 5 patients. Procedure-related complications occurred in 1 patient secondary to pain after the procedure, which was relieved by a steroid taper; otherwise, the patient had no evidence of other complication. No major complications occurred in the remaining 4 patients.

Conclusions: Trans-splenic access is a useful and safe technique for successful portal interventions.