Transjugular portosystemic shunt in chronic portal vein occlusion: importance of segmental portal hypertension in cavernous transformation of the portal vein.
J Vasc Interv Radiol
; 17(2 Pt 1): 373-8, 2006 Feb.
Article
en En
| MEDLINE
| ID: mdl-16517786
The authors describe a patient with bleeding varices due to chronic portal vein occlusion. A transjugular intrahepatic portosystemic shunt (TIPS) attempt failed because of cannulation of a low-pressure network of portal veins, which communicated only with the chronically thrombosed native portal vein. A second TIPS attempt was successful after transhepatic catheterization of a high-pressure portal system that was continuous with periportal collateral veins and mesenteric veins. After 8 months and one TIPS revision for hepatic vein stenosis, the patient has improved liver function, collapsed varices, and a patent TIPS on ultrasonogram. This case illustrates that cavernous transformation of the portal vein may result in variable intrahepatic portal perfusion and pressures and that TIPS in such cases requires careful selection of an intrahepatic portal vein to achieve adequate portal decompression.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Vena Porta
/
Derivación Portosistémica Intrahepática Transyugular
/
Trombosis de la Vena
/
Hipertensión Portal
Tipo de estudio:
Etiology_studies
Límite:
Aged
/
Female
/
Humans
Idioma:
En
Revista:
J Vasc Interv Radiol
Asunto de la revista:
ANGIOLOGIA
/
RADIOLOGIA
Año:
2006
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos