Although the large majority of cases are anatomically favorable and therefore technically feasible, congenital or acquired conditions may complicate or even preclude successful creation of a transjugular intrahepatic portosystemic shunt (TIPS). The present report describes the use of the inferior right hepatic vein from a femoral vein access to obtain portal access and place a covered stent, reconstruct a partially occluded portal vein, and embolize large gastric varices in a patient with a persistent left superior vena cava (SVC) and absent right SVC.
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http://dx.doi.org/10.1097/01.rvi.0000200054.73714.e1 | DOI Listing |
Endoscopy
January 2025
Gastroenterology and Hepatology, St Antonius Hospital, Nieuwegein, Netherlands.
Background Although endoscopic resection (ER) is recommended as first-choice treatment for early esophageal neoplasia, patients with esophageal varices are considered a high-risk group due to an increased bleeding risk. This systematic review aimed to evaluate the effectiveness and safety of ER in this specific patient category. Methods We searched for studies reporting on clinical outcomes of ER in presence of esophageal varices, irrespective of study design or follow-up time.
View Article and Find Full Text PDFInt J Numer Method Biomed Eng
January 2025
Hebei Provincial Key Laboratory of Portal Hypertension and Cirrhosis, Xingtai People's Hospital, Xingtai, China; Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
Transjugular intrahepatic portosystemic shunt (TIPS) is a widely used surgery for portal hypertension. In clinical practice, the diameter of the stent forming a shunt is usually selected empirically, which will influence the postoperative portal pressure. Clinical studies found that inappropriate portal pressure after TIPS is responsible for poor prognosis; however, there is no scheme to predict postoperative portal pressure.
View Article and Find Full Text PDFJ Vasc Interv Radiol
January 2025
Mallinckrodt Institute of Radiology, Washington University, Vascular and Intrventional Radiology. Electronic address:
Introduction: Recurrent portal hypertension (PH) after liver transplant (LT) and its management are not well-studied. This study aims to evaluate the impact of transjugular intrahepatic portosystemic shunt (TIPS) on outcomes of recurrent PH.
Methods: From a cohort of 1846 LT recipients, 36 patients who underwent TIPS creation after LT were identified and considered as cases.
J Vasc Interv Radiol
January 2025
Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Hospital, Durham, NC 27710. Electronic address:
Purpose: To compare costs of intravascular ultrasound (IVUS)-guided transjugular intrahepatic portosystemic shunt (TIPS) creation versus non-IVUS-guided TIPS creation, accounting for differences in procedure time and resource utilization.
Materials And Methods: This single institution retrospective study estimated procedure time and resource utilization from 157 consecutive elective TIPS creation procedures, of which 91 were IVUS-guided and 66 were non-IVUS-guided. Differences in procedure costs were derived using time-driven activity-based costing.
Objective: To evaluate the impact of intrahepatic portal vein branching (IHPB)-grade assessment using preoperative CT angiography (CTA) on the surgical procedure and prognosis prediction for dogs with an extrahepatic portosystemic shunt (EHPSS).
Methods: This study involved 146 client-owned dogs with EHPSS. The shunt morphology of EHPSS and IHPB grades was determined using CTA.
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