US-guided paraumbilical vein puncture: an adjunct to transjugular intrahepatic portosystemic shunt (TIPS) placement.
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.
Wenz
F
F
Department of Radiology, Northwestern Memorial Hospital, Chicago, IL 60611.
Nemcek
A A
AA
Tischler
H A
HA
Minor
P L
PL
Vogelzang
R L
RL
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