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Transcaval Transjugular Intrahepatic Portosystemic Shunt: Preliminary Clinical Results

Authors
 Kwang-Hun Lee  ;  Do-Yun Lee  ;  Woong Yoon  ;  Jae Kyu Kim  ;  Sang Joon Park  ;  Jong Yoon Won 
Citation
 KOREAN JOURNAL OF RADIOLOGY, Vol.4(1) : 35-41, 2003 
Journal Title
 KOREAN JOURNAL OF RADIOLOGY 
ISSN
 1229-6929 
Issue Date
2003
MeSH
Adult ; Aged ; Budd-Chiari Syndrome/complications ; Esophageal and Gastric Varices/surgery* ; Feasibility Studies ; Female ; Gastrointestinal Hemorrhage/surgery* ; Hepatic Veins/anatomy & histology ; Humans ; Male ; Middle Aged ; Portal Vein/anatomy & histology ; Portasystemic Shunt, Transjugular Intrahepatic/methods* ; Vena Cava, Inferior
Keywords
12679632
Abstract
Objective To determine the feasibility of transcaval transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with unusual anatomy between the hepatic veins and portal bifurcation, and inaccessible or inadequate hepatic veins. Materials and Methods Transcaval TIPS, performed in six patients, was indicated by active variceal bleeding (n=2), recurrent variceal bleeding (n=2), intractable ascites (n=1), and as a bridge to liver transplantation (n=1). The main reasons for transcaval rather than classic TIPS were the presence of an unusually acute angle between the hepatic veins and the level of the portal bifurcation (n=3), hepatic venous occlusion (n=2), and inadequate small hepatic veins (n=1). Results Technical and functional success was achieved in all patients. The entry site into liver parenchyma from the inferior vena cava was within 2 cm of the atriocaval junction. Procedure-related complications included the death of one patient due to hemoperitoneum despite the absence of contrast media spillage at tractography, and another suffered reversible hepatic encephalopathy. Conclusion In patients with unusual anatomy between the hepatic veins and portal bifurcation, and inaccessible or inadequate hepatic veins, transcaval TIPS creation is feasible.
Files in This Item:
T200306796.pdf Download
DOI
10.3348/kjr.2003.4.1.35
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hun(이광훈)
Lee, Do Yun(이도연)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/114478
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