Efficacy of puncturing different portal vein branch during transjugular intrahepatic portosystemic shunt with 8 mm covered stent

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Yongjie Zhou ◽  
Jingqin Ma ◽  
Shuai Ju ◽  
Zihan Zhang ◽  
Wen Zhang ◽  
...  
Author(s):  
Adam N. Plotnik ◽  
Stephen Kee

The “pay it forward off the balloon” technique for advancing the transjugular intrahepatic portosystemic shunt (TIPS) sheath may be employed during a difficult TIPS case when the interventionalist has already accessed the portal vein but cannot get the standard 10 Fr TIPS sheath through the fibrotic tract into the portal vein to thereby allow placement of a standard TIPS covered stent. In some patients, the fibrotic recoil of the parenchymal hepatic tract can be so severe that the basic balloon dilation maneuver fails. The pay it forward off the balloon technique employs the use of a 6 mm × 4-cm balloon, which is placed through the 10 Fr TIPS sheath and advanced over the wire and across the fibrotic tract into the portal vein.


2017 ◽  
Vol 01 (01) ◽  
pp. 20-26
Author(s):  
Abbas Chamsuddin ◽  
Lama Nazzal ◽  
Thomas Heffron ◽  
Osama Gaber ◽  
Raja Achou ◽  
...  

AbstractIntroduction: We describe a technique we call “Meso-transjugular intrahepatic portosystemic shunt (MTIPS)” for relief of portal hypertension secondary to portal vein thrombosis (PVT) using combined surgical and endovascular technique. Materials and Methods: Nine adult patients with PVT underwent transjugular intrahepatic portosystemic shunt through a combined transjugular and mesenteric approach (MTIPS), in which a peripheral mesenteric vein was exposed through a minilaparotomy approach. The right hepatic vein was accessed through a transjugular approach. Mechanical thrombectomy, thrombolysis, and angioplasty were performed when feasible to clear PVT. Results: All patients had technically successful procedures. Patients were followed up for a mean time of 13.3 months (range: 8 days to 3 years). All patients are still alive and asymptomatic. Conclusion: We conclude that MTIPS is effective for the relief of portal hypertension secondary to PVT.


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Jiaxiang Meng ◽  
Qing Wang ◽  
Kai Liu ◽  
Shuofei Yang ◽  
Xinxin Fan ◽  
...  

Lipopolysaccharide (LPS) and endothelin- (ET-) 1 may aggravate portal hypertension by increasing intrahepatic resistance and splanchnic blood flow. In the portal vein, after TIPS shunting, LPS and ET-1 were significantly decreased. Our study suggests that TIPS can benefit cirrhotic patients not only in high hemodynamics related variceal bleeding but also in intestinal bacterial translocation associated complications such as endotoxemia.


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