The Interventional Radiology Service

Story 2: Molly's Story

Molly is a 1 year old Bearded Collie. She was diagnosed with a shunt in her liver (intrahepatic portosystemic shunt), where there is an abnormal blood vessel that allows blood from the intestines to bypass the liver.

When this occurs, dogs become sick because the liver normally detoxifies this blood. In Molly’s case, she was quieter than normal for a young Bearded Collie and was quite small. Though the signs of this disease can be managed with medication, more definitive treatment is often recommended because of better long term outcomes. In Molly’s case, traditional treatment would have been an open abdominal surgery to locate the abnormal vessel in the liver and closing it. Because it is an invasive surgery, there is risk of bleeding and the recovery time can be several days. Instead, Molly had a more non-invasive treatment to close the abnormal vessel bypassing her liver. In this procedure, we used the jugular vein in her neck to access the shunt and close the vessel with coils from within the vessel itself. The entire procedure was performed through a catheter inserted in Molly’s neck so she recovered very quickly with no discomfort. She was kept in hospital for a few days for observation and has done fantastically since then. Her attitude and activity are better than they ever have been previously.

This video is an edited version using fluoroscopy of Molly’s procedure, called transjugular coil embolization of an intrahepatic portosystemic shunt. We access the abnormal vessel via the jugular vein using catheters and guide wires, then inject both the vena cava and shunt vessel with radiographic contrast. This allows for measurements of the vena cava for the vascular stent, which will hold the coils in place within the shunt vessel. The stent is then deployed and coils are inserted on the far side of the stent, within the shunt vessel. These coils then increase the pressure in the shunt vessel, redirecting blood instead into the liver itself as would normally occur.