# Postoperative Management of Portal Vein Arterialization: An Interdisciplinary Institutional Approach

## TL;DR

This paper introduces a standardized postoperative care protocol for portal vein arterialization to improve patient safety and outcomes.

## Contribution

The paper presents a tailored standard operating procedure for radiologists to manage portal vein arterialization complications.

## Key findings

- A lack of standardized protocols increases PVA-related complications like portal hypertension and thrombosis.
- The proposed SOP aims to enhance interdisciplinary collaboration and standardize postoperative care.
- The SOP is designed to improve patient outcomes by providing consistent guidelines for PVA management.

## Abstract

Portal vein arterialization (PVA) is a critical surgical intervention employed when hepatic artery blood flow restoration is unattainable. By redirecting arterial blood to the portal vein, PVA ensures adequate oxygenation of the liver. However, this procedure can induce complications such as portal hypertension and thrombosis if not meticulously managed. The absence of standardized postoperative care protocols exacerbates patient risks. In response, we have developed a standard operating procedure (SOP) tailored for radiologists. This modified SOP is designed to minimize complications and enhance patient outcomes by providing clear, consistent guidelines for post-surgical care, thereby fostering improved interdisciplinary collaboration. Our initiative aims to standardize PVA care, ensuring safer and more effective outcomes for patients requiring this procedure.

Portal vein arterialization (PVA) is a surgical procedure that plays a crucial role in hepatic vascular salvage when hepatic artery flow restoration remains elusive. Dedicated diagnostic vascular imaging and the timely management of PVA shunts are paramount to preventing complications, such as portal hypertension and thrombosis. Regrettably, a lack of standardized postoperative management protocols for PVA has increased morbidity and mortality rates post-procedure. In response to this challenge, we developed a PVA standard operating procedure (SOP) tailored to the needs of interventional radiologists. This SOP is designed to harmonize postoperative care, fostering scientific comparability across cases. This concise brief report aims to offer radiologists valuable insights into the PVA technique and considerations for post-PVA care and foster effective interdisciplinary collaboration.