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Transjugular intrahepatic portocaval shunt after thrombus disruption in partially thrombosed portal veins |
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| Authors: | José I Bilbao Jesús M Longo Hervé Rousseau Vanessa de Villa Francisco Mansilla Javier Alvarez-Cienfuegos Francis Joffre Jesús Prieto |
| Institution: | (1) Department of Radiology, Clinica Universitaria de Navarra, Avenida Pio XII s/n, E-31008 Pamplona, Spain;(2) Department of Radiology, CHU Rangueil, 1 Avenue Jean Poulhes, F-31054 Toulouse, France;(3) Department of Surgery, Clinica Universitaria de Navarra, Avenida Pio XII s/n, E-31008 Pamplona, Spain;(4) Department of Internal Medicine, Clinica Universitaria de Navarra, Avenida Pio XII s/n, E-31008 Pamplona, Spain |
| Abstract: | 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. |
| Keywords: | Portal vein US Portal vein thrombosis Hypertension portal Shunt portocaval Liver interventional procedures |
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