title: Transjugular intrahepatic portosystemic shunt with accidental diagnosis of persistence of the left superior vena cava.
abstract: Transjugular intrahepatic portosystemic shunt (TIPSS) is considered a valid therapeutic option for the treatment of portal hypertension and its complications. The guidelines for this procedure have already been established on the basis of the normal vascular anatomy and of various technical radiological aspects. In some few rare cases, diagnosis of a congenital vascular anomaly can be made accidentally by interventional radiologists, making the procedure of the TIPSS placement extremely difficult or in some cases technically impossible. This report describes a rare vascular malformation characterized by the absence of the right superior vena cava and persistence of the left superior vena cava in a patient with a diagnosis of advanced liver cirrhosis who needed a TIPSS placement in order to control refractory ascites.
authors.affiliation: Department of Gastroenterology and Hepatology, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, University of Pittsburgh Medical Center, Via Tricomi 1, Palermo 90127, Italy. ipetridis2@hotmail.com
authors.forename: Ioannis
authors.initials: I
authors.lastname: Petridis
authors.forename: Roberto
authors.initials: R
authors.lastname: Miraglia
authors.forename: Gianluca
authors.initials: G
authors.lastname: Marrone
authors.forename: Salvatore
authors.initials: S
authors.lastname: Gruttadauria
authors.forename: Angelo
authors.initials: A
authors.lastname: Luca
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Vizzini
authors.forename: Bruno
authors.initials: B
authors.lastname: Gridelli
mesh_terms: D000368:Aged; D001201:Ascites / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D033162:Incidental Findings; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D010690:Phlebography; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000379:methods; D011172:Portography; D054079:Vascular Malformations / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000000981:diagnostic imaging