A double-wire technique for transjugular intrahepatic portosystemic shunt through a transabdominal-transjugular portosystemic approach

OBJECTIVE: The purpose of this article is to describe a double-wire technique for transjugular intrahepatic portosystemic shunt (TIPS) procedures in which a transabdominal-transjugular portosystemic route is created that allows placement of a safety wire and a working wire. The safety wire provides a backup for the loss of the portosystemic tract and straightens the transjugular portosystemic route through a two-hand technique to facilitate shunt creation. CONCLUSION: Potential advantages of this technique include a precise and expeditious procedure for pediatric patients and those with small and hard liver or with focal lesions.