EURORAD ESR

Case 489

Problems of TIPS - Potentially dangerous portal puncture site

Author(s)
D.Vorwerk
 
Patient
female, 31 year(s)
 
 
  • Figure 1
    TIPS tract too close to the portal bifurcation
     

    The TIPS needle hits the left portal branch very close to the portal bifurcation which is a potential source for extrahepatic bleeding because this section of the portal tree might be located extrahepatically

     
    Area of Interest: unknown; Imaging Technique: TIPS tract too close to the portal bifurcation;

    Second anulated view shows a similar close position that led to the decision to give upt his route

     
    Area of Interest: unknown; Imaging Technique: TIPS tract too close to the portal bifurcation;

    After a second attempt, the left portal branch was hit more peripherally in a safer position

     
    Area of Interest: unknown; Imaging Technique: TIPS tract too close to the portal bifurcation;
     
     
The TIPS needle hits the left portal branch very close to the portal bifurcation which is a potential source for extrahepatic bleeding because this section of the portal tree might be located extrahepatically
 
Second anulated view shows a similar close position that led to the decision to give upt his route
 
After a second attempt, the left portal branch was hit more peripherally in a safer position
 
 
 
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