EXPRESS: Outcome of 4 cats with cIHPSS treated by a modified PTCE technique.

Modified single-catheter PTCE via 6Fr sheath safely treats feline cIHPSS without vascular complications.

This case series describes a modified single-catheter percutaneous transvenous coil embolization (PTCE) technique for treating congenital intrahepatic portosystemic shunts (cIHPSS) in four cats from two institutions. Traditional PTCE requires dual catheters and 9 Fr vascular sheaths, which poses significant challenges in feline patients due to their smaller vascular anatomy. The modified technique utilized a smaller 6 Fr vascular sheath placed in the jugular vein, reducing vascular trauma risk. A 4 Fr Berenstein catheter was used sequentially for both diagnostic imaging (portogram/cavogram) and therapeutic intervention (pressure monitoring and coil deployment). Laser-cut stents were selected based on CT and cavogram measurements and positioned to occlude the shunt ostium. All four cats tolerated the procedure well with no reported complications related to venous trauma or portal hypertension. The modified single-catheter approach demonstrates comparable procedural duration to standard techniques while avoiding potential vascular complications associated with larger sheaths in cats, offering a viable alternative for feline interventional portosystemic shunt management.

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