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Percutaneous Ultrasound-Guided Superior and Inferior Mesenteric Vein Access for Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt: A Case Series
OBJECTIVE: To describe the technique and outcomes of mesenteric access under ultrasound guidance to perform portal vein recanalization–transjugular intrahepatic portosystemic shunt (PVR-TIPS). METHODS: Four patients (3 male: 1 female, mean age: 46.2 years; range 38–64 years) with portal vein thrombo...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer US
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7682948/ https://www.ncbi.nlm.nih.gov/pubmed/33230650 http://dx.doi.org/10.1007/s00270-020-02713-0 |
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author | Entezari, Pouya Riaz, Ahsun Thornburg, Bartley Salem, Riad |
author_facet | Entezari, Pouya Riaz, Ahsun Thornburg, Bartley Salem, Riad |
author_sort | Entezari, Pouya |
collection | PubMed |
description | OBJECTIVE: To describe the technique and outcomes of mesenteric access under ultrasound guidance to perform portal vein recanalization–transjugular intrahepatic portosystemic shunt (PVR-TIPS). METHODS: Four patients (3 male: 1 female, mean age: 46.2 years; range 38–64 years) with portal vein thrombosis (PVT) and cavernous transformation were eligible for PVR-TIPS. Due to inaccessible splenic vein (one patient with history of splenectomy and 3 patients with unavailable splenic vein during the procedure), noninvasive direct puncture of superior (n = 3) and inferior (n = 1) mesenteric vein was conducted under ultrasound guidance to obtain access for PVR-TIPS. RESULTS: Trans-mesenteric access and PVR-TIPS were successful in all patients at first attempt. No immediate complication was observed following the procedures. Follow-up imaging with computed tomography (CT) scan and Doppler ultrasound revealed patent TIPS and portal venous vasculature in all patients. CONCLUSION: Percutaneous noninvasive transmesenteric access is a feasible approach for PVR-TIPS in patients with inaccessible splenic veins. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00270-020-02713-0) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7682948 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-76829482020-11-24 Percutaneous Ultrasound-Guided Superior and Inferior Mesenteric Vein Access for Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt: A Case Series Entezari, Pouya Riaz, Ahsun Thornburg, Bartley Salem, Riad Cardiovasc Intervent Radiol Technical Note OBJECTIVE: To describe the technique and outcomes of mesenteric access under ultrasound guidance to perform portal vein recanalization–transjugular intrahepatic portosystemic shunt (PVR-TIPS). METHODS: Four patients (3 male: 1 female, mean age: 46.2 years; range 38–64 years) with portal vein thrombosis (PVT) and cavernous transformation were eligible for PVR-TIPS. Due to inaccessible splenic vein (one patient with history of splenectomy and 3 patients with unavailable splenic vein during the procedure), noninvasive direct puncture of superior (n = 3) and inferior (n = 1) mesenteric vein was conducted under ultrasound guidance to obtain access for PVR-TIPS. RESULTS: Trans-mesenteric access and PVR-TIPS were successful in all patients at first attempt. No immediate complication was observed following the procedures. Follow-up imaging with computed tomography (CT) scan and Doppler ultrasound revealed patent TIPS and portal venous vasculature in all patients. CONCLUSION: Percutaneous noninvasive transmesenteric access is a feasible approach for PVR-TIPS in patients with inaccessible splenic veins. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00270-020-02713-0) contains supplementary material, which is available to authorized users. Springer US 2020-11-23 2021 /pmc/articles/PMC7682948/ /pubmed/33230650 http://dx.doi.org/10.1007/s00270-020-02713-0 Text en © Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Technical Note Entezari, Pouya Riaz, Ahsun Thornburg, Bartley Salem, Riad Percutaneous Ultrasound-Guided Superior and Inferior Mesenteric Vein Access for Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt: A Case Series |
title | Percutaneous Ultrasound-Guided Superior and Inferior Mesenteric Vein Access for Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt: A Case Series |
title_full | Percutaneous Ultrasound-Guided Superior and Inferior Mesenteric Vein Access for Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt: A Case Series |
title_fullStr | Percutaneous Ultrasound-Guided Superior and Inferior Mesenteric Vein Access for Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt: A Case Series |
title_full_unstemmed | Percutaneous Ultrasound-Guided Superior and Inferior Mesenteric Vein Access for Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt: A Case Series |
title_short | Percutaneous Ultrasound-Guided Superior and Inferior Mesenteric Vein Access for Portal Vein Recanalization–Transjugular Intrahepatic Portosystemic Shunt: A Case Series |
title_sort | percutaneous ultrasound-guided superior and inferior mesenteric vein access for portal vein recanalization–transjugular intrahepatic portosystemic shunt: a case series |
topic | Technical Note |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7682948/ https://www.ncbi.nlm.nih.gov/pubmed/33230650 http://dx.doi.org/10.1007/s00270-020-02713-0 |
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