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

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

CVIR Endovascular Pub Date : 2023-06-08 DOI:10.1186/s42155-023-00379-6

Cornelia L A Dewald, Frank K Wacker, Benjamin Maasoumy, Jan B Hinrichs

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引用次数: 1

Abstract

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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门静脉再通-经颈静脉肝内门静脉系统分流术(PVR-TIPS)与肠系膜上静脉通路和球囊辅助分流放置。

背景:报道超声引导下经皮经肠系膜上静脉(SMV)球囊辅助门静脉再通-经颈静脉肝内门静脉系统分流术(pvrtips)治疗慢性门静脉和脾静脉闭塞患者的技术和结果。病例介绍:一名51岁非肝硬化严重门静脉高压症患者因PVR-TIPS入院。由于慢性门静脉和脾静脉阻塞，脾和肝通路均不可行。经皮超声引导下直接穿刺SMV以获得球囊辅助PVR-TIPS的通路。经肠系膜入路联合球囊穿刺技术治疗PVR-TIPS是成功的，术后未观察到立即并发症。随后的随访检查显示TIPS和SMV未见腹内出血迹象。结论:经皮超声引导肠系膜上静脉进入球囊辅助PVR-TIPS是一种可行的选择，在肝或脾不能进入的情况下。

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来源期刊

CVIR Endovascular Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.30

自引率

0.00%

发文量