Two cases of pancreatic arteriovenous malformations treated with coil embolization via percutaneous transhepatic portal vein approach

Endovascular treatment for pancreatic arteriovenous malformation (P-AVM) has primarily involved transarterial approach. Here, we present two patients with P-AVMs, both of whom were treated using a percutaneous transhepatic portal vein approach in which coil embolization of the aneurysmal draining vein was conducted without arterial embolization. Contrast-enhanced computed tomography revealed a P-AVM with several feeding arteries and minimal veins, with Yakes types IIIa and IIIb presented in Cases 1 and 2, respectively. In Case 1, no residual AVM was observed. In Case 2, several residual feeding arteries were observed immediately post-embolization; however, they further reduced in number after 4 months. In Case 2, the portal venous pressure decreased from 22 mmHg to 14 mmHg. No adverse events were observed during the follow-up.