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. 2022 Jun 22;5(1):28.
doi: 10.1186/s42155-022-00304-3.

Transfemoral recanalization of occluded TIPS

Tatjana Dell  1 , Ulrike Attenberger  2 , Christian Jansen  2 , Julian A Luetkens  2 , Michael Praktiknjo  2 , Daniel Kütting  2 , Carsten Meyer  2
Affiliations

Transfemoral recanalization of occluded TIPS

Tatjana Dell et al. CVIR Endovasc. .

Abstract

Purpose: To report the safety and efficacy of percutaneous transfemoral venous recanalization of occluded intrahepatic portosystemic stents (TIPS) in cases where the transjugular approach is not feasible.

Materials and methods: Between 2000 and 2020, 8 patients with occluded TIPS underwent recanalization via a percutaneous transfemoral venous access. Prior recanalization via a typical transjugular approach was attempted in all cases. Primary technical success was defined as successful crossing of the occlusion. Secondary technical success was defined as the rate of successful TIPS recanalization. Periprocedural complications were evaluated to assess procedural safety.

Results: In 8/8 patients transfemoral venous TIPS recanalization was successful. No procedure-related complications were observed.

Conclusions: The transfemoral venous approach is a safe and efficient alternative for TIPS recanalization in cases where the transjugular approach is not feasible.

Keywords: Occlusion; TIPS; TIPS recanalization; Transfemoral.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Recanalization of occluded intrahepatic portosystemic covered stent in a 41-year-old patient with Budd-Chiari syndrome where the transjugular approach was not feasible. A Transfemoral insertion of a reverse-curve catheter (5 Fr Simmons 1 catheter; Cordis) into the right liver-vein ostium. A hydrophilic guide wire (Terumo, Japan) was used to cross the occlusion, while maintaining tension on the catheter to ensure support while manipulating the wire through the occlusion. B Next, PTA was performed using a 4 mm balloon via the femoral access, which then C enabled transjugular insertion of a 4 Fr Vertebralis catheter into the TIPS/portal system; which had not been possible before. D Post-procedure portal venogram shows the restoration of the shunt function after balloon angioplasty and implantation of an additional stent-graft
See this image and copyright information in PMC

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