TIPS in Portal Vein Occlusions: Facilitation with Percutaneous Splenic Access

Citron, Steven J.; Brantley, Steven D.

doi:10.1016/s1051-0443(98)70283-0

Cited by 13 publications

(7 citation statements)

References 5 publications

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“…If puncture of the intrahepatic portal vein branch was impossible or if it failed, an ultrasound-guided percutaneous trans-splenic approach was attempted in patients without splenectomy (Figs. 3 and 4), as reported elsewhere [23,24]. Both the trans-hepatic and trans-splenic tracts were embolized with coils after TIPS.…”

Section: Tips-therapeutic Strategymentioning

confidence: 95%

Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with symptomatic portal hypertension in liver cirrhosis

Han

et al. 2011

Journal of Hepatology

209

203

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Section: Tips-therapeutic Strategymentioning

confidence: 95%

Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with symptomatic portal hypertension in liver cirrhosis

Han

et al. 2011

Journal of Hepatology

209

203

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“…Thrombotic occlusion of the portal vein increases the difficulty of the procedure and has prompted several variations in technique to improve technical success [7, 9–11]. However, when the thrombosis is chronic and associated with cavernous transformation, the success of TIPS has remained limited.…”

Section: Discussionmentioning

confidence: 99%

TIPS Placement via Combined Transjugular and Transhepatic Approach for Cavernous Portal Vein Occlusion: Targeted Approach

Jourabchi

McWilliams

Lee

et al. 2013

Case Reports in Radiology

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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.

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“…The treatment of portal vein thrombosis by thrombolysis and stenosis by balloon dilation and stent insertion in adults has been described previously (9,10,16). Stent treatment of PVO in adults has also been described (3,11). In children these interventions are more difficult than in adults due to the smaller organ size.…”

Section: Discussionmentioning

confidence: 99%

Interventional Treatment of Children with Portal Hypertension Secondary to Portal Vein Occlusion

Cwikiel

Keussen

Larsson³

et al. 2003

Eur J Pediatr Surg

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TIPS in Portal Vein Occlusions: Facilitation with Percutaneous Splenic Access

Cited by 13 publications

References 5 publications

Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with symptomatic portal hypertension in liver cirrhosis

Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with symptomatic portal hypertension in liver cirrhosis

TIPS Placement via Combined Transjugular and Transhepatic Approach for Cavernous Portal Vein Occlusion: Targeted Approach

Interventional Treatment of Children with Portal Hypertension Secondary to Portal Vein Occlusion

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