EURORAD ESR

Case 480

Percutaneous revision of acute TIPS thrombosis

Author(s)
D.Vorwerk
 
Patient
female, 31 year(s)
 
 
  • Figure 1
    TIPS thrombosis
     

    Selective angiography at the caval end of the TIPS tract shows complete thrombosis

     
    Area of Interest: unknown; Imaging Technique: TIPS thrombosis;

    Portography reveals patent portal vein but complete occlusion of the TIPS tract with the portal side of the stent touching the wall of the left portal vein

     
    Area of Interest: unknown; Imaging Technique: TIPS thrombosis;
     
     
  • Figure 2
    TIPS revision
     

    PTA alone partially reopens the tract but remaining thrombus is present. Entrance into the TIPS shunt is still deteriorated by the insufficient stent position

     
    Area of Interest: unknown; Imaging Technique: TIPS revision;

    Stent-in-stent placement immediately reopened the tract allowing an improved inflow that leads to hypoperfusion of the intrahepatic portal branches

     
    Area of Interest: unknown; Imaging Technique: TIPS revision;
     
     
Selective angiography at the caval end of the TIPS tract shows complete thrombosis
 
Portography reveals patent portal vein but complete occlusion of the TIPS tract with the portal side of the stent touching the wall of the left portal vein
 
PTA alone partially reopens the tract but remaining thrombus is present. Entrance into the TIPS shunt is still deteriorated by the insufficient stent position
 
Stent-in-stent placement immediately reopened the tract allowing an improved inflow that leads to hypoperfusion of the intrahepatic portal branches
 
 
 
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