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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2020; 4(02): 118-121
DOI: 10.1055/s-0040-1710153
Case Report

Repeat Stent Placement through Lateral Fenestration of the Existing Dysfunctioning DIPS Stent Graft: An Alternative to Parallel TIPS/DIPS Procedure in a Case of Blocked Primary TIPS/DIPS

Karan Manoj Anandpara
1   Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Amar Mukund
1   Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Ravindran Ramalingam
1   Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi, India
,
Rakhi Maiwall
2   Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
› Author Affiliations Funding This study was not supported by any funding.
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Abstract

A complication of transjugular and direct intrahepatic portosystemic stent (TIPS and DIPS) graft is stent blockage. Routinely described procedures for shunt revision include angioplasty, deployment of endoprosthesis, catheter-directed thrombolysis, or rarely performing a second parallel TIPS/DIPS. We describe a case of hepatic vein outflow tract obstruction who presented with DIPS blockage. We performed a revision where a new stent was placed by a lateral puncture through the fenestration of the existing dysfunctioning DIPS stent graft. In our opinion, this alternate technique has theoretical advantages over the conventionally described parallel TIPS/DIPS as it prevents the creation of a completely new long hepatic parenchymal tract.

Keywords

transjugular intrahepatic portosystemic shunt (TIPS) - direct intrahepatic portosystemic shunt (DIPS) - TIPS revision - portal hypertension - blocked TIPS


Publication History

Article published online:
14 August 2020

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