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Transhepatic venous access for catheter ablation of right and left side atrial arrhythmias in adults: challenges and outcomes.
Curr Probl Cardiol
January 2025
International arrhythmia center, Fundacion cardioinfatil - La Cardio, Division of Cardiology, Bogota, Colombia. Electronic address:
Introduction: Electrophysiologic (EP) procedures are typically performed via the femoral venous system, but in some patients, the inferior vena cava (IVC) is unavailable. The hepatic vein has emerged as a viable alternative to femoral access, providing an inferior route that accommodates large sheaths required for better catheter manipulation. Although the percutaneous transhepatic approach has been used successfully in the pediatric population, its use in adults is scarce, with a complication rate of approximately 5%.
View Article and Find Full Text PDFElectroencephalographic Features of Presumed Hepatic Encephalopathy in a Pediatric Dog with a Portosystemic Shunt-A Case Report.
Life (Basel)
January 2025
Neurology Service, Faculty of Veterinary Medicine, "Ion Ionescu de la Brad" Iași University of Life Sciences, 700489 Iași, Romania.
Hepatic encephalopathy (HE) in dogs is a metabolic disorder of the central nervous system that occurs secondarily to liver dysfunctions, whether due to acquired or congenital causes. A portosystemic shunt is the presence of abnormal communications between the hepatic vessels (portal and suprahepatic veins). As a result of this, the blood brought from the digestive tract through the portal vein bypasses the liver, and the unmetabolized components of the portal bloodstream enter directly into systemic circulation, causing clinical symptoms of metabolic encephalopathy (HE).
View Article and Find Full Text PDFEndovascular Downstaging: A New Method for Managing Renal Cell Carcinoma Tumor Thrombus Invading the Inferior Vena Cava Above the Hepatic Veins (Level III) or into the Heart (Level IV).
Cancers (Basel)
January 2025
Department of Urology, Tufts University Medical Center, 800 Washington St., Boston, MA 02111, USA.
Background: Renal cell carcinoma tends to invade venous structures, frequently extending beyond the inferior vena cava and into the heart itself, such as into the right atrium or right ventricle. Resection of tumor burden, particularly tumor thrombus, often requires cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA), which is not feasible for all patients.
Methods: Described in this study is a novel, minimally invasive endovascular approach involving endovascular thrombectomy as a viable approach in these select patients.
Predictive model of intrahepatic collateral vessels among hepatic veins in patients with liver tumors involving the caval confluence.
Surgery
January 2025
Department of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Hepatobiliary & General Surgery, IRCCS Humanitas Research Hospital, Milan, Italy. Electronic address:
Background: Communicating vessels among hepatic veins in patients with tumors invading/compressing hepatic veins at their caval confluence facilitate new surgical solutions. Although their recognition by intraoperative ultrasound has been described, the possibility of preoperative detection still remains uncertain. We aimed to develop a model to predict their presence before surgery.
View Article and Find Full Text PDFRspo3-mediated metabolic liver zonation regulates systemic glucose metabolism and body mass in mice.
PLoS Biol
January 2025
Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
The unique architecture of the liver consists of hepatic lobules, dividing the hepatic features of metabolism into 2 distinct zones, namely the pericentral and periportal zones, the spatial characteristics of which are broadly defined as metabolic zonation. R-spondin3 (Rspo3), a bioactive protein promoting the Wnt signaling pathway, regulates metabolic features especially around hepatic central veins. However, the functional impact of hepatic metabolic zonation, regulated by the Rspo3/Wnt signaling pathway, on whole-body metabolism homeostasis remains poorly understood.
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