Transcaval TIPS in Patients with Failed Revision of Occluded Previous TIPS
Korean Journal of Radiology
;
: 204-209, 2001.
Article
in English
| WPRIM
| ID: wpr-161553
ABSTRACT
OBJECTIVE:
To determine the feasibility of transcaval transjugular intrahepatic portosystemic shunt (TIPS) in patients with occluded previous TIPS. MATERIALS ANDMETHODS:
Between February 1996 and December 2000 we performed five transcaval TIPS procedures in four patients with recurrent gastric cardiac variceal bleeding. All four had occluded TIPS, which was between the hepatic and portal vein. The interval between initial TIPS placement and revisional procedures with transcaval TIPS varied between three and 31 months; one patient underwent transcaval TIPS twice, with a 31-month interval. After revision of the occluded shunt failed, direct cavoportal puncture at the retrohepatic segment of the IVC was attempted.RESULTS:
Transcaval TIPS placement was technically successful in all cases. In three, tractography revealed slight leakage of contrast materials into hepatic subcapsular or subdiaphragmatic pericaval space. There was no evidence of propagation of extravasated contrast materials through the retroperitoneal space or spillage into the peritoneal space. After the tract was dilated by a bare stent, no patient experienced trans-stent bleeding and no serious procedure-related complications occurred. After successful shunt creation, variceal bleeding ceased in all patients.CONCLUSION:
Transcaval TIPS placement is an effective and safe alternative treatment in patients with occluded previous TIPS and no hepatic veins suitable for new TIPS.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Portal Vein
/
Reoperation
/
Vena Cava, Inferior
/
Vascular Patency
/
Portasystemic Shunt, Surgical
/
Esophageal and Gastric Varices
/
Stents
/
Feasibility Studies
/
Treatment Failure
/
Portasystemic Shunt, Transjugular Intrahepatic
Limits:
Humans
/
Male
Language:
English
Journal:
Korean Journal of Radiology
Year:
2001
Type:
Article
Similar
MEDLINE
...
LILACS
LIS