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

Abstract

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
• TIPS
• Re-entry catheter