TIPS Placement via Combined Transjugular and Transhepatic Approach for Cavernous Portal Vein Occlusion : Targeted Approach
Joint Authors
McWilliams, Justin Pryce
Sauk, Steven
Kee, Stephen Thomas
Jourabchi, Natanel
Lee, Edward Wolfgang
Source
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-01-21
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Purpose.
We report a novel technique which aided recanalization of an occluded portal vein for transjugular intrahepatic portosystemic shunt (TIPS) creation in a patient with symptomatic portal vein thrombosis with cavernous transformation.
Some have previously considered cavernous transformation a contraindication to TIPS.
Case Presentation.
62-year-old man with chronic pancreatitis, portal vein thrombosis, portal hypertension and recurrent variceal bleeding presents with melena and hematemesis.
The patient was severely anemic, hemodynamically unstable, and required emergent portal decompression.
Attempts to recanalize the main portal vein using traditional transjugular access were unsuccessful.
After percutaneous transhepatic right portal vein access and navigation of a wire through the occluded main portal vein, an angioplasty balloon was inflated at the desired site of shunt takeoff.
The balloon was targeted and punctured from the transjugular approach, and a wire was passed into the portal system.
TIPS placement then proceeded routinely.
Conclusion.
Although occlusion of the portal vein increases difficulty of performing TIPS, it should not be considered an absolute contraindication.
We have described a method for recanalizing an occluded portal vein using a combined transhepatic and transjugular approach for TIPS.
This approach may be useful to relieve portal hypertension in patients who fail endoscopic and/or surgical therapies.
American Psychological Association (APA)
Jourabchi, Natanel& McWilliams, Justin Pryce& Lee, Edward Wolfgang& Sauk, Steven& Kee, Stephen Thomas. 2013. TIPS Placement via Combined Transjugular and Transhepatic Approach for Cavernous Portal Vein Occlusion : Targeted Approach. Case Reports in Radiology،Vol. 2013, no. 2013, pp.1-5.
https://search.emarefa.net/detail/BIM-486957
Modern Language Association (MLA)
Jourabchi, Natanel…[et al.]. TIPS Placement via Combined Transjugular and Transhepatic Approach for Cavernous Portal Vein Occlusion : Targeted Approach. Case Reports in Radiology No. 2013 (2013), pp.1-5.
https://search.emarefa.net/detail/BIM-486957
American Medical Association (AMA)
Jourabchi, Natanel& McWilliams, Justin Pryce& Lee, Edward Wolfgang& Sauk, Steven& Kee, Stephen Thomas. TIPS Placement via Combined Transjugular and Transhepatic Approach for Cavernous Portal Vein Occlusion : Targeted Approach. Case Reports in Radiology. 2013. Vol. 2013, no. 2013, pp.1-5.
https://search.emarefa.net/detail/BIM-486957
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-486957