Combined transhepatic and transvenous approach to hepatic vein stenosis after transjugular intrahepatic portosystemic shunt (TIPS).
We describe a simple technique for recatheterization of transjugular intrahepatic portosystemic shunts (TIPS) with severe hepatic vein ostial stenoses that are inaccessible to standard transvenous approaches. A small gauge needle is used to transhepatically introduce a guidewire into the shunt; the wire is passed through the hepatic vein stenosis, snared, and used to guide jugular or brachial catheters into the TIPS.
Haskal
Z J
ZJ
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
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D002404:Catheterization; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000473:pathology*; D006801:Humans; D008099:Liver; D016491:Peripheral Vascular Diseases / Q000209:etiology / Q000628:therapy; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects*; D015607:Stents