"Bottoms-up" portal venous recanalization TIPS (PVR-TIPS) utilizing a re-entry catheter

Alexander Loizides; Martin Freund; Heinz Zoller; Benedikt Schäfer

doi:10.1186/s42155-024-00510-1

"Bottoms-up" portal venous recanalization TIPS (PVR-TIPS) utilizing a re-entry catheter

CVIR Endovasc. 2024 Dec 23;7(1):91. doi: 10.1186/s42155-024-00510-1.

Authors

Alexander Loizides¹, Martin Freund², Heinz Zoller³, Benedikt Schäfer³

Affiliations

¹ Department of Radiology, Medical University Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.
² Department of Radiology, Medical University Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria. [email protected].
³ Department of Gastroenterology, Medical University Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria.

Abstract

Background: Three patients with portal hypertension and gastrointestinal bleeding due to non-cirrhotic portal vein thrombosis were treated with portal venous recanalization transjugular intrahepatic portosystemic shunt (PVR-TIPS) via a trans-splenic access.

Main body: A "bottoms-up" retrograde puncture of the right hepatic vein was performed using a re-entry catheter to gain access to the right hepatic vein. In all patients a successful retrograde puncture of the right hepatic vein was achieved, thereby restoring the splenoportal tract.

Conclusion: Our cases present an alternative approach to treat chronic portal vein thrombosis expanding the possibilities of the PVR-TIPS procedure.

Keywords: PVR-TIPS; Portal vein thrombosis; Re-entry catheter; TIPS.