INTRODUCTIONIntrahepatic congenital portosystemic shunts (CPSS) are less common in dogs than their extrahepatic counterparts, making up approximately 25% to 33% of the total (Berent & Tobias , Berent & Tobias ). For both types of CPSS, surgical attenuation is recommended to restore normal portal blood flow and resolve clinical signs (Berent & Tobias , Tivers et al. , Greenhalgh et al. , Tivers et al. ). However, intrahepatic CPSS (IHCPSS) can be challenging to manage surgically due to the location of the vessel within the liver parenchyma (Hunt et al. , White et al. , Berent & Tobias ). Surgical techniques for IHCPSS include suture ligation, ameroid constrictors, cellophane banding and hydraulic occluders (White et al. , Hunt et al. , Kummeling et al. , Adin et al. , Bright et al. , Mehl et al. ). Intravascular techniques with hepatic inflow occlusion have been used to allow attenuation of some IHCPSS, which is technically demanding (Breznock et al. , Hunt et al. , White et al. ). Some studies have reported a high rate of complications (47% to 77%) and mortality (12·5% to 27·3%) with surgical attenuation of IHCPSS (Komtebedde et al. , White et al. , Papazoglou
Journal of Small Animal Practice – Wiley
Published: Jan 1, 2018
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