Portal Endovascular Rendezvous Catheterization (PERC): An innovative transabdominal technique of accessing the portal vein for large animal translational vascular research

Abstract

Previously described techniques for portomesenteric venous wire access typically require specialized expertise, technical skills, and equipment. The aim of this paper is to describe Portal Endovascular Rendezvous Catheterization (PERC), a simpler approach to access the portal vein for large animal translational research purposes. Using Swine, this technique utilizes a hybrid approach with percutaneous access of the internal jugular vein and open transabdominal access of the portal vein. A through-and-through micropuncture of the portal vein into the inferior vena cava at the level of the hepatic parenchyma allows for the access wire to be snared and access sheath advanced into the portal venous system, which then allows for any indicated sampling or endovascular interventions in the portomesenteric venous circulation. PERC is more manageable than transjugular intrahepatic portosystemic shunt (TIPS) placement for portal venous access, and its use will allow a greater breadth of translational researchers to access the portal vein.