Document Detail

Direct intrahepatic cavo-portal shunts in Budd-Chiari syndrome: Role of simultaneous fluoroscopy and trans-abdominal ultrasonography.
MedLine Citation:
PMID:  17090843     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Transjugular intrahepatic porto-systemic shunt (TIPS) for Budd-Chiari syndrome (BCS) can be inserted from inferior vena cava or hepatic vein to portal vein. The former is performed when hepatic veins are not suitable and is technically more challenging. METHODS: In this retrospective study, 7 patients with chronic BCS needed cavo-portal shunt as hepatic veins were neither amenable to plasty nor provided access for TIPS placement. Simultaneous fluoroscopic and trans-abdominal ultrasound guidance was used at the time of portal vein puncture. RESULTS: Technical success and clinical improvement were obtained in all patients. Median 3 (range 1-4) attempts were needed to puncture the portal vein. There were no significant complications. Uncovered stents were used in six patients and stent occlusion was common, but could be managed by re-intervention. CONCLUSION: Cavo-portal shunt is an effective technique for patients with BCS uncontrolled by medical therapy. Additional trans-abdominal ultrasound in oblique parasagittal plane keeps the procedure safe.
Shyamkumar N Keshava; Gopi Krishna Kota; Thomas Mammen; R Jeyamani; Vinu Moses; Shalini Govil; George Kurian; George Chandy
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology     Volume:  25     ISSN:  0254-8860     ISO Abbreviation:  Indian J Gastroenterol     Publication Date:    2006 Sep-Oct
Date Detail:
Created Date:  2006-11-08     Completed Date:  2006-12-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8409436     Medline TA:  Indian J Gastroenterol     Country:  India    
Other Details:
Languages:  eng     Pagination:  248-50     Citation Subset:  IM    
Department of Radiology, Christian Medical College and Hospital, Vellore 632 004, India.
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MeSH Terms
Budd-Chiari Syndrome / diagnosis*,  radiography,  surgery*,  ultrasonography
Hepatic Veins / radiography,  ultrasonography
Middle Aged
Portasystemic Shunt, Transjugular Intrahepatic / methods*
Retrospective Studies
Treatment Outcome

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