Percutaneous CT-guided superior mesenteric vein access for portal vein recanalization-transjugular intrahepatic portosystemic shunt

Ghosh, Aloke; Seyoum, Nahom; Anand, Sheena; Akhter, Nabeel

doi:10.1016/j.radcr.2022.04.025

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Transmesenteric access via US and CT for PVR-TIPS in patients where the splenic vein is not accessible has been described [ 2 , 4 ]. A small series of 4 patients where transmesenteric US access was used for PVR-TIPS described 100% technical success, TIPS patency at 1 month, and no complications [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Successful direct intrahepatic portosystemic shunt (DIPS) creation following transmesenteric porta hepatis access in a young patient with recurrent variceal bleeding

Tanaka,

Yamada,

Kalva

2023

CVIR Endovasc

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Background Transmesenteric access for portal vein reconstruction and transjugular intrahepatic portosystemic shunt allows for intervention in patients with unfavorable anatomy and can be performed via multiple methods but may be difficult to obtain in patients with complex anatomy. Case presentation We present a case report describing a method of obtaining transmesenteric access in the porta hepatis to facilitate direct intrahepatic portosystemic shunt creation in a young patient with recurrent variceal bleeding. This patient anatomy was unfavorable, and initially he was thought to be a poor candidate for any intervention, but this technique allowed for successful decompression of the varices safely and effectively. Conclusions This is a technique to consider in similar complex cases and expands treatment for those who previously would not have been considered for intrahepatic shunt formation. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Successful direct intrahepatic portosystemic shunt (DIPS) creation following transmesenteric porta hepatis access in a young patient with recurrent variceal bleeding

Tanaka,

Yamada,

Kalva

2023

CVIR Endovasc

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Safety of Percutaneous Transmesenteric and Transsplenic Access for Portosystemic Shunt Creation in Patients with Portal Vein Obstruction: Single-Center Experience and Review of Literature

Steffen

Najafi

Binkert

2023

Cardiovasc Intervent Radiol

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Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) with superior mesenteric vein access and balloon-assisted shunt placement

et al. 2023

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Background To report the technique and outcome of ultrasound-guided percutaneous access to the superior mesenteric vein (SMV) for balloon-assisted portal vein recanalization–transjugular intrahepatic portosystemic shunt (PVR-TIPS) in a patient with chronic portal venous and splenic vein occlusion. Case presentation A 51-year-old, non-cirrhotic patient with severe portal hypertension was admitted for PVR-TIPS. Neither splenic nor hepatic access was feasible due to chronic portal and splenic vein occlusion. Percutaneous ultrasound-guided direct puncture of the SMV was performed to obtain access for balloon-assisted PVR-TIPS. The transmesenteric approach in combination with a balloon puncture technique for PVR-TIPS was successful, and no immediate complications were observed post-procedure. The subsequent follow-up exams showed patent TIPS and SMV without signs of intraabdominal hemorrhage. Conclusion Percutaneous ultrasound-guided superior mesenteric vein access for balloon-assisted PVR-TIPS is a feasible option in cases where hepatic or splenic access is not.

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Percutaneous CT-guided superior mesenteric vein access for portal vein recanalization-transjugular intrahepatic portosystemic shunt

Cited by 3 publications

References 10 publications

Successful direct intrahepatic portosystemic shunt (DIPS) creation following transmesenteric porta hepatis access in a young patient with recurrent variceal bleeding

Successful direct intrahepatic portosystemic shunt (DIPS) creation following transmesenteric porta hepatis access in a young patient with recurrent variceal bleeding

Safety of Percutaneous Transmesenteric and Transsplenic Access for Portosystemic Shunt Creation in Patients with Portal Vein Obstruction: Single-Center Experience and Review of Literature

Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) with superior mesenteric vein access and balloon-assisted shunt placement

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