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A successful endovascular repositioning of migrated transjugular intrahepatic portosystemic shunt (TIPS) stent.

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العنوان: A successful endovascular repositioning of migrated transjugular intrahepatic portosystemic shunt (TIPS) stent.
المؤلفون: Mirchia K; State University of New York Upstate Medical University, Department of Interventional Radiology, 750 East Adams Street, Syracuse, NY 13210, USA., Thibodeau R; State University of New York Upstate Medical University, Department of Interventional Radiology, 750 East Adams Street, Syracuse, NY 13210, USA., Goel A; State University of New York Upstate Medical University, Department of Interventional Radiology, 750 East Adams Street, Syracuse, NY 13210, USA., Jafroodifar A; State University of New York Upstate Medical University, Department of Interventional Radiology, 750 East Adams Street, Syracuse, NY 13210, USA., Babin I; State University of New York Upstate Medical University, Department of Interventional Radiology, 750 East Adams Street, Syracuse, NY 13210, USA., Jawed M; State University of New York Upstate Medical University, Department of Interventional Radiology, 750 East Adams Street, Syracuse, NY 13210, USA., Hu Z; State University of New York Upstate Medical University, Department of Interventional Radiology, 750 East Adams Street, Syracuse, NY 13210, USA., Love Z; State University of New York Upstate Medical University, Department of Interventional Radiology, 750 East Adams Street, Syracuse, NY 13210, USA., Tewari S; State University of New York Upstate Medical University, Department of Interventional Radiology, 750 East Adams Street, Syracuse, NY 13210, USA.
المصدر: Radiology case reports [Radiol Case Rep] 2020 Nov 28; Vol. 16 (2), pp. 278-283. Date of Electronic Publication: 2020 Nov 28 (Print Publication: 2021).
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101467888 Publication Model: eCollection Cited Medium: Print ISSN: 1930-0433 (Print) Linking ISSN: 19300433 NLM ISO Abbreviation: Radiol Case Rep Subsets: PubMed not MEDLINE
أسماء مطبوعة: Publication: 2015-: Amsterdam : Elsevier
Original Publication: Seattle, WA : University of Washington, 2006-
مستخلص: The transjugular intrahepatic portosystemic shunt (TIPS) procedure is performed to create an intrahepatic tract between the hepatic and portal veins which helps to shunt blood away from the hepatic sinusoids. This shunt decreases the portal venous pressure and secondary morbidities, including variceal bleeding and recurrent ascites. However, stent migration is a known complication of TIPS stent placement which may occur both during the procedure or postprocedural. We present a case of a 58-year-old male with history of liver cirrhosis in the setting of alcohol abuse and chronic hepatitis C infection who presented with melena and hematemesis. Esophagogastroduodenoscopy showed 4 columns of large grade IV esophageal varices with stigmata of recent bleeding. Despite endoscopic variceal banding, the patient had persistent episodes of hematemesis and became hemodynamically unstable requiring pressor support. The decision was made to proceed with emergent transjugular intrahepatic portosystemic shunt placement. After obtaining transhepatic portal access and initial stent deployment, the stent migrated from the TIPS tract into the main portal vein. While maintaining through-and-through wire access, the stent was successfully mechanically retracted using an angioplasty balloon and it was appropriately repositioned within the original TIPS tract. The stent was then further secured in place with a slightly larger stent which was deployed within the hepatic portion of the initially migrated stent. This technique was successful and obviated complete removal of the stent and follow-up imaging demonstrated patent flow and adequate positioning several months after the procedure.
(© 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
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فهرسة مساهمة: Keywords: Balloon angioplasty; Cirrhosis; Endovascular repositioning; Portal hypertension, Esophageal Varices; Stent migration; Transjugular intrahepatic portosystemic shunt
تواريخ الأحداث: Date Created: 20201210 Latest Revision: 20201211
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC7708652
DOI: 10.1016/j.radcr.2020.11.010
PMID: 33299509
قاعدة البيانات: MEDLINE
الوصف
تدمد:1930-0433
DOI:10.1016/j.radcr.2020.11.010