24 - Transhepatic Access Closure for Islet Cell Transplant in Anticoagulated Patients: A Comparison of Microfibrillar Collagen Paste, Coils, and Coil Plus Gel Foam

Monday, April 13, 2026

12:10 PM - 1:10 PM ET

Location: Poster Hall (800 level)

Poster Presenter(s)

Wesley Lim, MD

Resident Physician
University of Chicago Medical Center, United States

Author/Co-author(s)

Qian Yu, MD (he/him/his)

Resident
University of Chicago, United States
PT

Patrick Tran, MD

Resident Physician
University of Chicago, United States
EU

Ethan Ungchusri, MD

Resident
University of Chicago, United States
KK

Kunal Karani, MD

Interventional Radiology
University of Chicago, United States
AK

Abdul Khan, MD, RPVI

Assistant Professor
University of Chicago, United States
Mikin V. Patel, MD, MBA (he/him/his)

President, Interventional Radiologist
Joint and Vascular Institute, United States
Osman Ahmed, MD, FSIR

Professor of Radiology
University of Utah, United States
TV

Thuong Van Ha, MD

Professor
University of Chicago, United States
JL

Jonathan Lorenz, MD, FSIR

Professor of Radiology
The University of Chicago, United States
Steven Zangan, MD

Associate Professor
University of Chicago, United States
BF

Brian Funaki, MD, FSIR

Professor of Radiology
University of Chicago, United States
Rakesh C. Navuluri, MD, FSIR

Associate Professor
University of Chicago, United States

Purpose: To evaluate the safety and effectiveness of microfibrillar collagen paste (MCP), coils, and coils combined with gel foam for transhepatic access tract embolization following portal vein islet cell transplant.

Materials and Methods: A retrospective review was conducted at a single institution between January 2008 and October 2024, including 20, 28, and 21 consecutive islet cell transplant procedures requiring transhepatic access embolization with MCP, coils, and coil plus gel foam, respectively. All procedures were performed via a right portal vein branch. MCP was performed using Avitene (BD). The average number of coils required in the coil plus gel foam and coil-only groups were 1.8 and 1.6 coils per procedure, respectively. All patients were placed on therapeutic anticoagulation during the procedure and for at least two weeks post-transplant. Medical records were reviewed to compare laboratory results, portal venous pressures, post-procedure liver ultrasounds, and 30-day hemorrhagic events across the three groups.

Results: All procedures were technically successful. However, one instance of coil migration into a portal vein branch occurred in the coil plus gel foam group (1/28, 3.5%). Baseline hemoglobin, platelet counts, and partial thromboplastin time did not differ significantly between groups (p > 0.05). A statistically significant lower international normalized ratio (INR) was observed in the MCP group compared to the gel foam and coil-only groups (1.0 vs. 1.1 vs. 1.1, p = 0.0036 and 0.004). No statistically significant differences were found in hemoglobin changes, post-transplant portal venous pressures, or post-embolization hemorrhagic events (p > 0.05). One patient in the coil plus gel foam group developed a large subcapsular hematoma (1/27, 3.7%), while another in the MCP group experienced a large right hemothorax (1/20, 5.0%).

Conclusion: MCP, coils, and coil plus gel foam are similarly effective for transhepatic access closure following islet cell transplant in anticoagulated patients. However, coil embolization may require multiple coils and carries a risk of migration.