Percutaneous Transhepatic Revision of Occluded Intrahepatic Portosystemic Shunt

Introduction: This study aimed to describe a two-center experience of recanalization of the intrahepatic portosystemic shunt (TIPS) with the ultrasound-guided percutaneous transhepatic direct puncture of the TIPS stent when the standard transjugular approach is inaccessible.

Method(s): Recanalization of occluded bare stent started with the puncture by 18G or a 21G needle. After passing occluded segments with 0.0035 or 0.0018-inch glide wire, this wire was grasped with an Amplantz goose-neck snare and pulled out from the jugular vein. After that, the procedure continued with standard TİPS revision.

Result(s): A total of 118 TİPS procedures were performed in this study. Sixty-three patients required TIPS revision on the follow-up. Of the 63 patients, nine revisions were performed with the percutaneous stent puncture technique. Technical success was 100%, and no procedural complications were observed.

Conclusion(s): Percutaneous ultrasound-guided direct puncture of the TIPS stent recanalization is safe and had excellent technical and clinical success when the standard transjugular approach is inaccessible.

Publication History

Article published online:
09 February 2023