title: US-guided paraumbilical vein puncture: an adjunct to transjugular intrahepatic portosystemic shunt (TIPS) placement.
abstract: Transjugular intrahepatic portosystemic stent-shunt placement has shown great promise as a means of protal decompression in patients with severe portal hypertension. Passage of a needle from the hepatic venous system into the portal venous system during this procedure may be technically difficult; while it would be advantageous to precisely target the portal vein, most methods of localization are themselves technically difficult, risky, or time-consuming. The authors describe a method of localization of the portal vein that, when feasible, appears to be both safe and technically simple. This method involves percutaneous catheterization of a paraumbilical portosystemic collateral vein under sonographic guidance.
authors.affiliation: Department of Radiology, Northwestern Memorial Hospital, Chicago, IL 60611.
authors.forename: F
authors.initials: F
authors.lastname: Wenz
authors.forename: A A
authors.initials: AA
authors.lastname: Nemcek
authors.forename: H A
authors.initials: HA
authors.lastname: Tischler
authors.forename: P L
authors.initials: PL
authors.lastname: Minor
authors.forename: R L
authors.initials: RL
authors.lastname: Vogelzang
mesh_terms: D000328:Adult; D006396:Hematemesis / Q000628:therapy*; D006801:Humans; D007601:Jugular Veins; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D011677:Punctures / Q000379:methods*; D015607:Stents; D014463:Ultrasonography; D014471:Umbilical Veins / Q000000981:diagnostic imaging