Transhepatic ultrasound guided embolization as a successful novel technique in treatment of pediatric complex intrahepatic arterioportal fistula: a case report and review of the literature

Table 1 Norton-Jacobson classification of IAPF [12]

Afferent supply	Description of afferent vessel(s)	Initial treatment
Unilateral	RHA or LHA or main HA only	TAE
Bilateral	Both RHA and LHA* or equivalent supply from main HA^†	TAE Ligation if TAE fails
Complex	RHA and/or LHA and no hepatic arterial supply^‡	Ligation/surgery^§

^*Both parent hepatic arteries and/or branches from both parent arteries
^†Equivalent supply from the main hepatic artery may take the place of one of the parent arteries
^‡Examples of other arteries include celiac, superior mesenteric, gastric, gastroduodenal, inferior phrenic, pancreaticoduodenal, jejunal, cystic, adrenal and splenic arteries
^§The current case was the first case of congenital IAPF treated exclusively by TAE; thus, data are insufficient to recommend TAE as initial therapy at this time
IAPF intrahepatic arterioportal fistula, RHA right hepatic artery, LHA left hepatic artery, HA hepatic artery, TAE transarterial embolization(s)

ISSN: 1752-1947