Transjugular intrahepatic portocaval shunt after thrombus disruption in partially thrombosed portal veins.
Portal vein (PV) thrombosis increases the risk of variceal bleeding in cirrhotic patients with portal hypertension. Its presence also complicates PV access during transjugular porto-caval shunt (TIPS) placement. We overcame this obstacle by using ultrasound (US) guidance for PV entry. Clot disruption by balloon catheters was then performed before placing the vascular endoprostheses for portal-venous shunting. We treated 3 cirrhotic patients in such fashion with good clinical results. Portal thrombi progressively disappeared after shunting due to both balloon disruption and the rise in portal blood flow velocity.
Department of Radiology, Clinica Universitaria de Navarra, Pamplona, Spain.
J I
JI
Bilbao
J M
JM
Longo
H
H
Rousseau
V
V
de Villa
F
F
Mansilla
J
J
Alvarez-Cienfuegos
F
F
Joffre
J
J
Prieto
D002404:Catheterization; D004932:Esophageal and Gastric Varices / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D013927:Thrombosis / Q000150:complications / Q000628:therapy*; D018084:Ultrasonography, Interventional