The protective effect of portoarterial shunts after experimental hepatic artery embolization in rats with liver cirrhosis

The role of the portal system after hepatic artery embolization (HAE) was examined. Using a Wistar strain rat model of liver cirrhosis, the route and occurrence of portoarterial (PA) shunts before and after HAE by scanning electron microscopic (SEM) and histologic methods were evaluated. HAE was performed with iodized oil and gelatin sponge particles. In the SEM study, PA shunts did not develop in normal rats regardless of whether they did (n = 10) or did not have HAE (n = 5). The cirrhotic rat model showed PA shunts in both HAE (n = 5) and non-HAE (n = 5) animals. PA shunts were established via the peribiliary plexus and direct arterioportal anastomosis. In the histologic study, the occurrence of PA shunts in liver cirrhosis was significantly increased by HAE (HAE = 6, non-HAE = 6, p < 0.01). The development of PA shunts, which help perfuse liver parenchyma, may explain why HAE can be safely performed in patients with liver cirrhosis.