Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) with superior mesenteric vein access and balloon-assisted shunt placement

BACKGROUND: To report the technique and outcome of ultrasound-guided percutaneous access to the superior mesenteric vein (SMV) for balloon-assisted portal vein recanalization–transjugular intrahepatic portosystemic shunt (PVR-TIPS) in a patient with chronic portal venous and splenic vein occlusion....

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Autores principales: Dewald, Cornelia L. A., Wacker, Frank K., Maasoumy, Benjamin, Hinrichs, Jan B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250275/
https://www.ncbi.nlm.nih.gov/pubmed/37289270
http://dx.doi.org/10.1186/s42155-023-00379-6
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author Dewald, Cornelia L. A.
Wacker, Frank K.
Maasoumy, Benjamin
Hinrichs, Jan B.
author_facet Dewald, Cornelia L. A.
Wacker, Frank K.
Maasoumy, Benjamin
Hinrichs, Jan B.
author_sort Dewald, Cornelia L. A.
collection PubMed
description BACKGROUND: To report the technique and outcome of ultrasound-guided percutaneous access to the superior mesenteric vein (SMV) for balloon-assisted portal vein recanalization–transjugular intrahepatic portosystemic shunt (PVR-TIPS) in a patient with chronic portal venous and splenic vein occlusion. CASE PRESENTATION: A 51-year-old, non-cirrhotic patient with severe portal hypertension was admitted for PVR-TIPS. Neither splenic nor hepatic access was feasible due to chronic portal and splenic vein occlusion. Percutaneous ultrasound-guided direct puncture of the SMV was performed to obtain access for balloon-assisted PVR-TIPS. The transmesenteric approach in combination with a balloon puncture technique for PVR-TIPS was successful, and no immediate complications were observed post-procedure. The subsequent follow-up exams showed patent TIPS and SMV without signs of intraabdominal hemorrhage. CONCLUSION: Percutaneous ultrasound-guided superior mesenteric vein access for balloon-assisted PVR-TIPS is a feasible option in cases where hepatic or splenic access is not.
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spelling pubmed-102502752023-06-10 Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) with superior mesenteric vein access and balloon-assisted shunt placement Dewald, Cornelia L. A. Wacker, Frank K. Maasoumy, Benjamin Hinrichs, Jan B. CVIR Endovasc Case Report BACKGROUND: To report the technique and outcome of ultrasound-guided percutaneous access to the superior mesenteric vein (SMV) for balloon-assisted portal vein recanalization–transjugular intrahepatic portosystemic shunt (PVR-TIPS) in a patient with chronic portal venous and splenic vein occlusion. CASE PRESENTATION: A 51-year-old, non-cirrhotic patient with severe portal hypertension was admitted for PVR-TIPS. Neither splenic nor hepatic access was feasible due to chronic portal and splenic vein occlusion. Percutaneous ultrasound-guided direct puncture of the SMV was performed to obtain access for balloon-assisted PVR-TIPS. The transmesenteric approach in combination with a balloon puncture technique for PVR-TIPS was successful, and no immediate complications were observed post-procedure. The subsequent follow-up exams showed patent TIPS and SMV without signs of intraabdominal hemorrhage. CONCLUSION: Percutaneous ultrasound-guided superior mesenteric vein access for balloon-assisted PVR-TIPS is a feasible option in cases where hepatic or splenic access is not. Springer International Publishing 2023-06-08 /pmc/articles/PMC10250275/ /pubmed/37289270 http://dx.doi.org/10.1186/s42155-023-00379-6 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Case Report
Dewald, Cornelia L. A.
Wacker, Frank K.
Maasoumy, Benjamin
Hinrichs, Jan B.
Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) with superior mesenteric vein access and balloon-assisted shunt placement
title Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) with superior mesenteric vein access and balloon-assisted shunt placement
title_full Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) with superior mesenteric vein access and balloon-assisted shunt placement
title_fullStr Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) with superior mesenteric vein access and balloon-assisted shunt placement
title_full_unstemmed Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) with superior mesenteric vein access and balloon-assisted shunt placement
title_short Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt (PVR-TIPS) with superior mesenteric vein access and balloon-assisted shunt placement
title_sort portal vein recanalization–transjugular intrahepatic portosystemic shunt (pvr-tips) with superior mesenteric vein access and balloon-assisted shunt placement
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250275/
https://www.ncbi.nlm.nih.gov/pubmed/37289270
http://dx.doi.org/10.1186/s42155-023-00379-6
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