embolization of Capillary Veins in Portal Vein

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Regular Member

Date Joined Jan 2012
Total Posts : 281
   Posted 5/20/2016 11:57 AM (GMT -6)   
Hi guys. Haven't been on a while ... encephalopathy was getting rough. Wanted to share the latest to see if anyone else has had a similar experience. Maybe could shed some light, give advice?

The latest MRI shows only 20% of blood is flowing through the portal vein. They've known my body creating capillary veins that circumvent the portal vein for quite a while and have been monitoring it. My hepatologist says they've now "grown up" and are taking 80% of the blood flow. Encephalopathy has been quite unstable. Many hospital visits, many days of taking lactulose hourly. I'm on Rifaximin too. They've also done lactulose laxatives in hospital.

They've decided to do an embolization ... they do it like an angiogram. Done by an "interventional radiologist" with catheter through vein in groin to go up and block the blood flow of the capillary veins and force the blood back into the portal vein. He will be able to tell while he's in there if the portal vein is viable to take the extra blood flow (it's been 10 years since it worked reasonably well). If it can't then they do a TIPS right afterwards, and reverse the procedure to allow lessened pressure on the portal vein. My hepatologist assures me that they will keep the diameter of the TIPS as small as possible to prevent or lessen encephalopathy IF they do have to do the TIPS at all.

So the end result is it could fix it ... or I'd be just in the same or a little better shape than before the procedure.

Apparently this case is unusual in that my liver function is still quite good. Usually my symptoms would come with a much more grumpy liver. I did the Hep C treatment with Harvoni and was cleared in July 2015.

Has anyone heard of this? They're all excited about it at the liver clinic ... say my chances are really good. I feel a bit like a lab rat but am willing to take the chance that it will help. In Canada they don't use encephalopathy in the score for transplant. So they say they can't trust the score numbers (which may not accurately reflect the status of the liver). My INR is high but I'm on Warfarin because of the portal vein trouble. My Bilirubin is sometimes high, but not often and not for long. My liver enzymes normalized more than they have in years, after Hep C treatment. I have slight edema but not ascites. Hepatologist says I do have a hardened liver which may also be a reason the blood won't flow as it should.

Hope others are well ... sorry for not being in touch. I'm not on social media much these days at all ... or the telephone. LOL ... trying to protect folks from my HE days. Still live alone trying to handle all of this. Not great fun. Today's a good day.

ppm guy
Veteran Member

Date Joined Apr 2010
Total Posts : 1226
   Posted 5/20/2016 5:59 PM (GMT -6)   
hi H&C,
my twin has esld and hcc.
he completed the harvoni treatment, and has been undetected for months. his latest tests also reveal a small improvement in function. being svr, removes the chronic inflamation.

he doesnt want a transplant, and is stable doing targeted treatments. he lives alone also.

Forum Moderator

Date Joined Oct 2010
Total Posts : 4838
   Posted 5/21/2016 12:43 PM (GMT -6)   
H&C, This is a symptom I have not come across before. MIke never needed a TIPS and though he had everything else in the book, he did not need TIPS nor did he ever have ascited...instead his legs swelled to his testes from edema. He had the retching, uncontrolled diarrhea from lactulose, HE, very high LFTs, etc.

But now he has almost normal labs post TP, post Hep C treatment, post Aortic Valve Replacement and 5 ortho surgeries (shoulders and elbows). He is bionic now and doing as well as can be expected. Reaching the 5 year post TP was a milestone. He may still have some years left on his liver and heart valve!

Best to you. Keep us posted.

Mama Lama
MamaLama, Forum moderator - Hepatitis
Partner received liver transplant (May 1, 2011) FL
Hep C 1a Treatment - Sovaldi/Olysio (March - May 2014)
Undetected since week 4. Undetected 12 weeks post treatment.
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