Transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of venous symptomatic chronic portal thrombosis in non-cirrhotic patients

Cardiovascular and Interventional Radiology
José I BilbaoAlberto Benito

Abstract

To present a series of cases of non-cirrhotic patients with symptomatic massive portal thrombosis treated by percutaneous techniques. All patients underwent a TIPS procedure in order to maintain the patency of the portal vein by facilitating the outflow. A total of six patients were treated for thrombosis of the main portal vein (6/6); the main right and left branches (3/6) and the splenic vein (5/6) and superior mesenteric vein (6/6). Two patients had a pancreatic malignancy; one patient with an orthotopic liver transplant had been surgically treated for a pancreatic carcinoma. Two patients had idiopathic thrombocytosis, and in the remaining patient no cause for the portal thrombosis was identified. During the initial procedure in each patient one or more approaches were tried: transhepatic (5/6), transileocolic (1/6), trans-splenic (1/6) or transjugular (1/6). In all cases the procedure was completed with a TIPS with either ultrasound guidance (3/6), "gun-shot" technique (2/6) or fluoroscopic guidance (1/6). No complications were observed during the procedures. One patient had a repeat episode of variceal bleeding at 30 months, one patient remained asymptomatic and was lost to follow-up at 24 months, two patients were success...Continue Reading

Citations

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