Radiology, Vol 186, 523-527, Copyright © 1993 by Radiological Society of North America
Transjugular intrahepatic portosystemic shunts in patients with portal vein occlusion
PM Radosevich, EJ Ring, JM LaBerge, MY Peltzer, ZJ Haskal, MM Doherty and RL Gordon
Department of Radiology, University of California, San Francisco 94143- 0628.
The feasibility and efficacy of transjugular intrahepatic portosystemic
shunts (TIPS) were evaluated in 10 patients with preexisting portal vein
occlusions. A standard transjugular approach was used in six of the 10
patients for both portal vein recanalization and TIPS placement. The protal
veins were successfully recanalized and TIPS were established in three of
the six patients. TIPS placement was unsuccessful in the other three
patients because the catheters could not be advanced through the occluded
segments. A transhepatic approach was used in four of the 10 patients for
portal vein recanalization before transjugular catheterization and TIPS
placement were attempted. Both portal vein recanalization and TIPS
placement were technically successful in all four patients. Bleeding
stopped in all patients after successful shunt placement. TIPS can be used
to control variceal bleeding in some patients, despite preexisting portal
vein occlusion. Preliminary recanalization of the occluded portal segment
by means of the transhepatic approach may facilitate TIPS placement.
