Transsplenic portal vein reconstruction–transjugular intrahepatic portosystemic shunt in a patient with portal and splenic vein thrombosis

Jason T. Salsamendi, Francisco J. Gortes, Michelle Shnayder, Mehul H. Doshi, Ji Fan, Govindarajan Narayanan

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Portal vein thrombosis (PVT) is a potential complication of cirrhosis and can worsen outcomes after liver transplant (LT). Portal vein reconstruction–transjugular intrahepatic portosystemic shunt (PVR-TIPS) can restore flow through the portal vein (PV) and facilitate LT by avoiding complex vascular conduits. We present a case of transsplenic PVR-TIPS in the setting of complete PVT and splenic vein (SV) thrombosis. The patient had a 3-year history of PVT complicated by abdominal pain, ascites, and paraesophageal varices. A SV tributary provided access to the main SV and was punctured percutaneously under ultrasound scan guidance. PV access, PV and SV venoplasty, and TIPS placement were successfully performed without complex techniques. The patient underwent LT with successful end-to-end anastomosis of the PVs. Our case suggests transsplenic PVR-TIPS to be a safe and effective alternative to conventional PVR-TIPS in patients with PVT and SV thrombosis.

Original languageEnglish (US)
Pages (from-to)186-189
Number of pages4
JournalRadiology Case Reports
Volume11
Issue number3
DOIs
StatePublished - Sep 1 2016

Keywords

  • Portal vein reconstruction
  • TIPS
  • Thrombosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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