Large Spontaneous Intrahepatic Portal-Systemic Venous Shunt Treated With Coil and Amplatzer Vascular Plug Embolization

Spontaneous intrahepatic portal-systemic shunts are rare and can lead to significant encephalopathy. If intervention is recommended, transcatheter embolization is preferred. Various embolization techniques have been described using a wide range of embolization materials. In this report, the authors describe a useful embolization technique for managing a complex, large type 3 spontaneous intrahepatic portal-systemic shunt using Nester coils and Amplatzer vascular plugs through both percutaneous systemic and transhepatic approaches.