{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:17:28Z","timestamp":1793146648889,"version":"4.5.0"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin intervent Radiol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Portosystemic collateral pathways are a significant concern in interventional radiology, frequently manifesting in patients with cirrhosis or portal vein thrombosis. These pathways can lead to severe clinical complications, including gastrointestinal bleeding, hepatic encephalopathy, and liver failure. A thorough understanding of the anatomy, hemodynamic alterations, and clinical implications of these shunts is crucial for interventional radiologists to provide effective treatment while minimizing risks. This article reviews the clinical presentations associated with portosystemic shunts, explores the anatomical variants and altered flow dynamics, and discusses the latest endovascular treatment strategies to optimize patient outcomes.<\/jats:p>","DOI":"10.1055\/s-0045-1802346","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T23:43:21Z","timestamp":1740095001000},"page":"124-132","source":"Crossref","is-referenced-by-count":1,"title":["Understanding Portosystemic Collateral Anatomy"],"prefix":"10.1055","volume":"42","author":[{"given":"Aaron","family":"McBride","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Wallace","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indravadan","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"Ozen","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1148\/radiol.2021203051","article-title":"Relevance of spontaneous portosystemic shunts detected with CT in patients with cirrhosis","volume":"299","author":"S Nardelli","year":"2021","journal-title":"Radiology"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/j.crad.2015.06.077","article-title":"Portal hypertension: a review of portosystemic collateral pathways and endovascular interventions","volume":"70","author":"A K Pillai","year":"2015","journal-title":"Clin Radiol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1111\/j.1440-1746.2010.06262.x","article-title":"Long-term results of balloon-occluded retrograde transvenous obliteration for gastric fundal varices: hepatic deterioration links to portosystemic shunt syndrome","volume":"25","author":"M Kumamoto","year":"2010","journal-title":"J Gastroenterol Hepatol"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1055\/s-0034-1382795","article-title":"Portosystemic shunt syndrome and endovascular management of hepatic encephalopathy","volume":"31","author":"W E Saad","year":"2014","journal-title":"Semin Intervent Radiol"},{"issue":"08","key":"ref5","doi-asserted-by":"crossref","first-page":"868","DOI":"10.4254\/wjh.v13.i8.868","article-title":"Unpacking the challenge of gastric varices: a review on indication, timing and modality of therapy","volume":"13","author":"K Vaz","year":"2021","journal-title":"World J Hepatol"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1186\/s12876-020-01513-7","article-title":"Beyond the scope and the glue: update on evaluation and management of gastric varices","volume":"20","author":"C A Philips","year":"2020","journal-title":"BMC Gastroenterol"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"168","DOI":"10.4253\/wjge.v6.i5.168","article-title":"Update on gastric varices","volume":"6","author":"M Triantafyllou","year":"2014","journal-title":"World J Gastrointest Endosc"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1055\/s-0031-1284456","article-title":"Anatomy and classification of gastrorenal and gastrocaval shunts","volume":"28","author":"S S Sabri","year":"2011","journal-title":"Semin Intervent Radiol"},{"issue":"10","key":"ref9","first-page":"1244","article-title":"Gastric varices: profile, classification, and management","volume":"84","author":"S K Sarin","year":"1989","journal-title":"Am J Gastroenterol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"6170243","DOI":"10.1155\/2016\/6170243","article-title":"A comprehensive review of portosystemic collaterals in cirrhosis: historical aspects, anatomy, and classifications","volume":"2016","author":"C A Philips","year":"2016","journal-title":"Int J Hepatol"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s002619900068","article-title":"Transjugular retrograde obliteration for gastric varices","volume":"21","author":"F Chikamori","year":"1996","journal-title":"Abdom Imaging"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1148\/rg.234025135","article-title":"Transcatheter obliteration of gastric varices: Part 2. 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