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

Simultaneous portogram/cavogram and continuous portal pressure monitoring during coil deployment are standard practices during percutaneous transvenous coil embolization (PTCE) for the interventional treatment of congenital intrahepatic shunts (cIHPSS). In cats, vascular access is more challenging due to their smaller size. The minimum vascular sheath size required to accommodate standard instrumentation for dual catheter PTCE is 9 Fr, which can be challenging to place in the feline jugular vein. The objective of this case series was to retrospectively describe a single catheter modification of the PTCE technique in cats to avoid complications associated with large vascular sheaths and the outcomes of these cats. Four cats from two different institutions underwent single-catheter PTCE for left divisional IHPSS between January 2024 and May 2025. Data collected from medical records included patient demographic data, and peri- and post-procedural data. Single-catheter PTCE was performed in all cats through a 6Fr vascular sheath percutaneously placed in the jugular vein. Isolated portogram and cavogram were performed to localize the shunt, measure caval diameter, and determine caval stent positioning using a 4Fr Berenstein catheter. A laser cut stent was selected based on computed tomography and cavogram measurements and positioned to span the shunt ostium. The same Berenstein catheter was used for portal pressure measurement and coil deployment by alternating between the shunt and portal vein locations. No complications associated with venous trauma or portal hypertension were reported. Scientific or clinical relevance and novel information: The case series results suggest the modified PTCE technique is viable alternative that was associated with reasonable procedural duration and avoided vascular complications that may be associated with large vascular sheaths in cats.