Abstract No. 623 Technique of maintaining portal venous access and obtaining a more central portal vein puncture when the initial peripheral access may be prone to technical difficulties and potential serious complications

2018 ◽  
Vol 29 (4) ◽  
pp. S259
Author(s):  
R. Peng ◽  
M. Jagust ◽  
Y. Golowa ◽  
J. Cynamon
Keyword(s):  
Portal Vein ◽  
Venous Access ◽  
Central Portal

Deployment of Direct Intrahepatic Portocaval Shunt (DIPS) from a Femoral Access

2018 ◽  
Author(s):  
Abdulrahman Masrani ◽  
Bulent Arslan
Keyword(s):  
Portal Vein ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Access ◽  
Hepatic Veins ◽  
Portocaval Shunt ◽  
Femoral Access ◽  
Direct Puncture ◽  
The Right ◽  
Brachiocephalic Veins

The transjugular intrahepatic portosystemic shunt (TIPS) has been shown to be effective in management of esophageal varices bleeding in patients with liver cirrhosis when endoscopic manuvers fail to control it. Ascites refractory to optimal medical therapy is another indication for TIPS procedure. Occasionally, TIPS cannot be performed due to vascular anatomical difficulties such as occluded central venous access, small hepatic veins, or portal vein occlusion. Direct intrahepatic portocaval shunt (DIPS) can be considered as an alternative option in such circumstances. DIPS is typically performed utilizing jugular access with direct puncture from the inferior vena cava (IVC) to the right portal vein. However, the interventionalist may be challenged by jugular or brachiocephalic veins occlusion. This chapter discusses perfroming DIPS procedure utilizing femoral access in a patient with bilateral occluded brachiocephalic veins and thrombosed right portal vein.

Use of Prolapsing Guidewire to Secure Portal Venous Access During the TIPS Procedure

2018 ◽  
Author(s):  
Thomas Kinney ◽  
Kazim Narsinh
Keyword(s):  
Portal Vein ◽  
Venous Access ◽  
Acute Angle ◽  
Portosystemic Shunt ◽  
Portal System ◽  
Main Portal Vein ◽  
Access Site ◽  
Shunt Procedure ◽  
Intrahepatic Portosystemic Shunt ◽  
Critical Portion

Perhaps the most critical portion of the transjugular intrahepatic portosystemic shunt procedure involves obtaining secure portal venous access. An acute angle of entry into the portal venous system during intrahepatic portosystemic shunt creation can make retrograde advancement of a guidewire into the splenic or superior mesenteric vein difficult. However, securing access from the jugular access site to the portal system with a reliable guidewire is of critical importance during the procedure. This chapter presents a technique to advance a flexible-tip guidewire antegrade into right portal vein branches prior to prolapsing the guidewire into the main portal vein to secure transjugular portal venous access.

scholarly journals Innovative application of an implantable venous access system in the portal vein: technique, results and complications in three dogs

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Kiona S. de Nies ◽  
Hedwig S. Kruitwagen ◽  
Giora van Straten ◽  
Leonie W. L. van Bruggen ◽  
Joris H. Robben ◽  
...  
Keyword(s):  
Portal Vein ◽  
Venous Access ◽  
Access System

scholarly journals Hybrid Management of Acute Portal Vein Thrombosis Complicated by Mesenteric Ischemia

2022 ◽  
Vol 5 (3) ◽  
Author(s):  
Sayuri P Jinadasa ◽  
Mira Ghneim ◽  
Brittany O Aicher ◽  
Rishi Kundi ◽  
John Karwowski ◽  
...  
Keyword(s):  
Portal Vein ◽  
Operating Room ◽  
Portal Vein Thrombosis ◽  
Mesenteric Ischemia ◽  
Hybrid Approach ◽  
Venous Access ◽  
Vein Thrombosis ◽  
Hybrid Management ◽  
Efficient Care

Treatment for portal vein thrombosis complicated by mesenteric ischemia can be treated in the operating room following a hybrid approach. This allows for efficient care of the patient, avoids the need for transhepatic cannulation for obtaining a venogram and placing a thrombolysis catheter, and obviates the need to obtain percutaneous venous access.

The removal and morphology of intact biofilms from implanted venous access devices

1995 ◽  
Vol 53 ◽  
pp. 1020-1021
Author(s):  
M.A. Gregory ◽  
G.P. Hadley
Keyword(s):  
Patient Selection ◽  
Surgical Oncology ◽  
Venous Access ◽  
Common Procedure ◽  
Indwelling Catheters ◽  
Careful Patient ◽  
Novel Method ◽  
The Subject ◽  
Vascular Catheters ◽  
Venous Access Devices

The insertion of implanted venous access systems for children undergoing prolonged courses of chemotherapy has become a common procedure in pediatric surgical oncology. While not permanently implanted, the devices are expected to remain functional until cure of the primary disease is assured. Despite careful patient selection and standardised insertion and access techniques, some devices fail. The most commonly encountered problems are colonisation of the device with bacteria and catheter occlusion. Both of these difficulties relate to the development of a biofilm within the port and catheter. The morphology and evolution of biofilms in indwelling vascular catheters is the subject of ongoing investigation. To date, however, such investigations have been confined to the examination of fragments of biofilm scraped or sonicated from sections of catheter. This report describes a novel method for the extraction of intact biofilms from indwelling catheters.15 children with Wilm’s tumour and who had received venous implants were studied. Catheters were removed because of infection (n=6) or electively at the end of chemotherapy.

An ultrastructural study on the shark liver

1990 ◽  
Vol 48 (3) ◽  
pp. 512-513
Author(s):  
Masako Yamada ◽  
Yutaka Tanuma
Keyword(s):  
Portal Vein ◽  
Kupffer Cells ◽  
Ultrastructural Study ◽  
Lipid Droplets ◽  
Microscopic Level ◽  
The Other ◽  
Fish Stock ◽  
Structural Studies ◽  
Light Microscopic Level ◽  
Perfusion Fixation

Although many fine structural studies on the vertebrate liver have been reported on mammals, avians, reptiles, amphibians, teleosts and cyclostomes, there are no studies on elasmobranchii liver except one by T. Ito etal. (1962) who studied it on light microscopic level. The purpose of the present study was to as certain the ultrastructural details and cytochemical characteristics of normal elasmobranchii liver and was to compare with the other higher vertebrate ones.Seventeen Scyliorhinus torazame, one kind of elasmobranchii, were obtained from the fish stock of the Ueno Zoo aquarium, Ueno, Tokyo. The sharks weighing about 300-600g were anesthetized with MS-222 (Sigma), and the livers were fixed by perfusion fixation via the portal vein according to the procedure of Y. Saito et al. (1980) for 10 min. Then the liver tissues were immersed in the same fixative for 2 hours and postfixed with 1% OsO4-solution in 0.1 Mc acodylate buffer for one hour. In order to make sure a phagocytic activity of Kupffer cells, latex particles (0.8 μm in diameter, 0.05mg/100 g b.w.) were injected through the portal vein for one min before fixation. For preservation of lipid droplets in the cytoplasm, a series of these procedure were performed under ice cold temperature until the end of dehydration.

Factors Influencing Pressure in the Portal Vein as Studied in the Intact Animal

1950 ◽  
Vol 16 (1) ◽  
pp. 194-210 ◽  
Author(s):  
Frederick W. Hoffbauer ◽  
Jesse L. Bollman ◽  
John L. Grindlay
Keyword(s):  
Portal Vein ◽  
Intact Animal ◽  
Factors Influencing

Median sternotomy for an unexpected complication of permanent hemodialysis catheters: "stuck catheter"

VASA ◽  
2008 ◽  
Vol 37 (3) ◽  
pp. 293-296 ◽  
Author(s):  
Akgun ◽  
Ak ◽  
Tugrular ◽  
Civelek ◽  
Isbir ◽  
...  
Keyword(s):  
Essential Role ◽  
Median Sternotomy ◽  
Venous Access

Cuffed tunneled venous access catheters are commonly used for temporary and permanent access in patients undergoing hemodialysis. These catheters play an essential role in providing permanent access in patients in whom all other access options have been exhausted. However, they are prone to several complications like catheter thrombosis, catheter fibrin sheating and infection. Herein, we report two uncommon cases of stuck hemodialysis cuffed tunneled catheters causing stenosis and thrombosis in central veins which needed to be removed by median sternotomy.

The Glissonian Approach of the Hilum

Swiss Surgery ◽  
1999 ◽  
Vol 5 (3) ◽  
pp. 143-146 ◽  
Author(s):  
Launois ◽  
Maddern ◽  
Tay
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Posterior Approach ◽  
Hepatic Duct ◽  
Rapid Evolution ◽  
Hepatic Tissue ◽  
Detailed Knowledge ◽  
Porta Hepatis ◽  
Liver Segment ◽  
Glissonian Approach

The detailed knowledge of the segmental anatomy of the liver has led to a rapid evolution in resectional surgery based on the intrahepatic distribution of the portal trinity (the hepatic artery, hepatic duct and portal vein). The classical intrafascial or extrahepatic approach is to isolate the appropriate branch of the portal vein, hepatic artery and the hepatic duct, outside the liver substance. Another method, the extrafascial approach, is to dissect the whole sheath of the pedicle directly after division of a substantial amount of the hepatic tissue to reach the pedicle, which is surrounded by a sheath, derived from Glisson's capsule. This Glissonian sheath encloses the portal trinity. In the transfissural or intrahepatic approach, these sheaths can be approached either anteriorly (after division of the main, right or umbilical fissure) or posteriorly from behind the porta hepatis. We describe the technique for approaching the Glissonian sheath and hence the hepatic pedicle structures and their branches by the intrahepatic posterior approach that allows early delineation of the liver segment without the need for ancillary techniques. In addition, the indications for the use of this technique in the technical and oncologic settings are also discussed.

Sign in / Sign up

Export Citation Format

Share Document