Sequential doppler sonographic studies of embolization in a patient with hepatic involvement in hereditary hemorrhagic telangiectasia: Correlation with angiographic findings
Journal
Journal of the Formosan Medical Association
Journal Volume
98
Journal Issue
9
Pages
633-638
Date Issued
1999
Author(s)
Abstract
A 41-year-old man was admitted for symptoms of progressive congestive heart failure. His family history and the results of a physical examination were highly suggestive of Osler-Weber-Rendu disease (hereditary hemorrhagic telangiectasia, HHT). Cardiac catheterization and hepatic angiography demonstrated HHT with left-to-right shunting from the liver. The patient underwent transcatheter arterial embolization (TAE) of the right hepatic artery. We performed both Doppler sonography and angiography before and after TAE. The treatment improved the clinical manifestations of congestive heart failure, including the edema of the leg and dyspnea. Doppler sonographic studies also showed an increased resistive index in the right hepatic artery and decreased flow volumes and velocities in the right and middle hepatic veins, respectively, after treatment. Corresponding changes on angiography after TAE showed decreased right hepatic arterial flow and nonopacified branches distal to the coils, disappearance of the mottled hepatogram in the right lobe, reduction of contrast agent staining, and enhanced calibers in the right and middle hepatic veins. This case illustrates that qualitative and quantitative studies with duplex and color Doppler ultrasound can be used to detect or define the extent of hepatic involvement in HHT patients before TAE, monitor hemodynamic changes of the intrahepatic vasculature after TAE, evaluate the efficacy of treatment, and possibly obviate the need for repeated angiography for diagnosis only.
Subjects
Doppler sonography; Hepatic angiography; Hereditary hemorrhagic telangiectasia; Osler-Weber-Rendu disease; Transcatheter arterial embolization
SDGs
Other Subjects
adult; article; artificial embolism; case report; congestive heart failure; doppler flowmetry; heart catheterization; hemodynamics; hepatic artery; hepatic vein; human; liver angiography; male; Rendu Osler Weber disease; Adult; Arteriovenous Fistula; Blood Flow Velocity; Embolization, Therapeutic; Hepatic Artery; Hepatic Veins; Humans; Male; Telangiectasia, Hereditary Hemorrhagic; Ultrasonography, Doppler; Vascular Resistance
Type
journal article