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Fig. 6A. —Single intrahepatic portosystemic venous shunt in 72-year-old woman who did not have cirrhosis and who presented in coma. Blood examination revealed hyperammonemia and low Fischer's ratio. Patient was treated by retrograde transcaval obliteration. Retrograde transcaval portography was performed with catheter advanced into portal vein via shunt vessel (arrowhead). Portogram shows intrahepatic portosystemic venous shunt between right portal vein and accessory hepatic vein (open arrow) with portal vein aneurysm (solid arrow). Gianturco coil (William Cook Europe, Bjaeverskov, Denmark), detachable microcoils, and fibered platinum microcoils were positioned in shunt just before aneurysmal dilatation.

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