Percutaneous creation of direct intrahepatic portosystemic shunts – an alternative for failed TIPS creation

Abstract

Introduction Direct intrahepatic portosystemic shunt creation is a feasible and safe alternative for transjugular intrahepatic portosystemic shunt creation. It needs equipment like endovascular ultrasound with restricted availability. We performed the procedure percutaneously with a common interventional armamentarium to make it more feasible. Methods Retrospective analysis of 8 percutaneous DIPS insertions between 2016 and 2020. Results The procedure was successful in 8/8 patients. There was no short-term death reported within 30 days. The longest reported patency is 5 years. Conclusion Percutaneous DIPS creation is a feasible alternative for failed TIPS. Percutaneously the procedure can be completed faster than conventional DIPS using only minimal puncture equipment. Level of evidence Level 4, Case Series.

Successful surgical management of cardiac tamponade following direct intrahepatic portosystemic shunt in a child with Budd–Chiari syndrome: A potentially life-threatening situation

“…In 2001, an endovascular alternative, called DIPS, was published by Petersen and Binkert[ 3 ] It has been reported as a feasible and safe endovascular alternative to TIPS insertion. [ 4 ] The original DIPS technique described by Peterson et al involved the use of endovascular ultrasound to guide the puncture site of the portal vein and for the introduction of guide wire. Following numerous modifications to this technique, a percutaneous technique to approach the portal vein has been widely accepted.…”