TIPS performed in a patient with complete portal vein thrombosis

Sharma, Ashwani; Kaufman, David

doi:10.1016/j.radcr.2017.01.013

Cited by 8 publications

(3 citation statements)

References 10 publications

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“…TIPS procedures have been successfully performed in patients with portal vein occlusion due to thrombosis. TIPS has shown good efficacy in cases involving PVT ( 4 , 22 ). The patient, experiencing severe portal vein blockage, underwent a splenectomy before the TIPS procedure.…”

Section: Discussionmentioning

confidence: 99%

Case report: Management of liver cancer complicated by gastric varices rupture and bleeding: transjugular intrahepatic portosystemic shunt utilizing the mesenteric venous pathway

Sun,

Wang,

Zhang

et al. 2024

Front. Med.

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To avoid recurrent variceal bleeding, transjugular intrahepatic portosystemic shunt (TIPS) in conjunction with variceal embolization is considered to be an effective strategy. However, due to changes in conditions and variations in the patient's state, individuals undergoing TIPS may face challenges and limitations during procedures. The transjugular technique and combined transsplenic portal venous recanalization (PVR) with TIPS were not effective in this case due to a blocked portal vein and a previous splenectomy. With an abdominal incision, we successfully punctured the mesenteric venous system and navigated the occluded segment of the portal vein through the mesenteric approach. TIPS was then performed under balloon guidance. This study aims to explore the management of risks and complications during surgical operations and propose multiple preoperative surgical techniques to improve the success rate of the procedure.

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Section: Discussionmentioning

confidence: 99%

Case report: Management of liver cancer complicated by gastric varices rupture and bleeding: transjugular intrahepatic portosystemic shunt utilizing the mesenteric venous pathway

Sun,

Wang,

Zhang

et al. 2024

Front. Med.

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“…Portal vein thrombosis, once considered a contraindication for TIPS, has indeed become an ""indication"" in the setting of cirrhotic and non-cirrhotic cases 18,30,31 . The potential concerns in performing TIPS in a patient with acute portal vein thrombosis would be increased technical difficulty in performing the procedure as their blood cannot be freely aspirated from the portal vein after the puncture, a gradient across the stent cannot always be established, and the risk for pulmonary embolism when portal venous thrombolysis is done through TIPS tract.…”

Section: Discussionmentioning

confidence: 99%

Conservative short-term treatment of non-cirrhotic non-malignant portal vein thrombosis

et al. 2023

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Introduction. Portal vein (PV) thrombosis (PVT) is a partial or a complete obstruction of blood flow as a result of a thrombus mass in the lumen of PV. In the acute phase, the symptoms are unspecific such as right upper quadrant pain, nausea and fever. Diversity of subacute and chronic symptoms are associated with complications related to PVT and portal hypertension. Case report. We are presenting a case of a 50-year-old female who was admitted in hospital due to acute abdominal cramping pain. The pain lasted for 15 to 20 minutes, and was followed by defecation of normal stool and haematochezia in three occasions. The abdominal pain returned in several hours, again followed by haematochezia and tenesmuses every 10 minutes. After admission a colonoscopy was performed that determined vulnerable, erythematous mucosa of the colon with contact bleeding from lienal flexure to rectosigmoid junction. During the colonoscopy, a biopsy was performed. A computer tomography (CT) scan revealed partial PVT, thrombosis of intrahepatic branches of PV and thrombosis of the inferior mesenteric vein. After conservative treatment with low molecular weight heparin (LWMH), and other supportive measures the digestive bleeding ceased, and defecation became normal. During one month follow up a patient has had no complications and control CT scan revealed normal PV flow without thrombosis. Conclusion: Although is a rare, a non-malignant and non-cirrhotic PVT in differential diagnosis should not be neglected because timely and vigilant therapy with LWMH can lead to complete resolution without serious complication.

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“…In cirrhotic patients with concomitant PVT, indications for TIPS also include contraindications to anticoagulation, progression of thrombosis despite anticoagulation, and PVT in a liver transplant candidate. Given the technical challenges associated with nonvisualization of the portal vein during TIPS, 5 portal vein recanalization using a trans-splenic approach has gained popularity. 6 7 Herein, we present our experience with using a trans-splenic approach to TIPS in cirrhotic and noncirrhotic patients with PVT.…”

Section: Introductionmentioning

confidence: 99%

Trans-splenic Approach for Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation in Patients with Portal Vein Thrombosis

Boumezrag,

Lynskey,

Sabri

2024

The Arab Journal of Interventional Radiology

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Purpose The aim of this study was to evaluate the safety and efficacy of using a trans-splenic approach for transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with portal vein thrombosis. (PVT). Materials and Methods A retrospective review was performed on 36 consecutive patients with PVT who underwent TIPS using a trans-splenic approach from February 2018 to June 2021. Preprocedural data including demographic information and Model for End-Stage Liver Disease (MELD) scores were obtained. Outcomes measured included technical success, clinical success, complications, and survival. Results Technical success was achieved in 32 of 36 patients (89%). During the follow-up period, 16 of 32 (50%) required secondary TIPS interventions, most of which were planned as part of a staged procedure. TIPS patency was 30/32 (94%) had stent patency on their most recent follow-up with a median follow-up of 164 days. No patients had variceal bleeding following TIPS. Eleven of thirty-two (34%) patients underwent successful transplant after TIPS. Anatomical portal vein end-to-end anastomosis was achieved in 11/12 (92%) patients. Conclusion The trans-splenic approach to TIPS is a reliable alternative to traditional TIPS in patients with PVT and provides high technical and clinical success rates. This technique can also be utilized to improve future liver transplant outcomes by facilitating anatomic portal vein end-to-end anastomoses.

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TIPS performed in a patient with complete portal vein thrombosis

Cited by 8 publications

References 10 publications

Case report: Management of liver cancer complicated by gastric varices rupture and bleeding: transjugular intrahepatic portosystemic shunt utilizing the mesenteric venous pathway

Case report: Management of liver cancer complicated by gastric varices rupture and bleeding: transjugular intrahepatic portosystemic shunt utilizing the mesenteric venous pathway

Conservative short-term treatment of non-cirrhotic non-malignant portal vein thrombosis

Trans-splenic Approach for Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation in Patients with Portal Vein Thrombosis

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