Transjugular intrahepatic portocaval shunt after thrombus disruption in partially thrombosed portal veins
Bilbao JI, Longo JM, Rousseau H, de Villa V, Mansilla F, Alvarez-Cienfuegos J, Joffre F, Prieto J.
Department of Radiology, Clinica Universitaria de Navarra, Pamplona, Spain
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.
CITATION Cardiovasc Intervent Radiol. 1994 Mar-Apr;17(2):106-9