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Transjugular portosystemic shunt insertion

Case contributed by Andrew Lawson
Diagnosis certain

Presentation

Portal hypertension.

Patient Data

Age: 50 years
Gender: Male

Ultrasound guided placement of 0.018, 10 mm Hilal straight coil via 22g Chiba needle to mark portal vein. Right internal jugular 10Fr access. Left hepatic vein entered and tract to umbilical portion of the left portal vein balloon dilated over guide wire with a 6 x 40 mm balloon (Evercross). 10 x 80 mm partially covered (60 mm covered) Viatorr stent placed over wire from left portal vein to distal middle hepatic vein. Post deployment dilatation with 56 x 40 and 7 x 40 mm balloons (Evercross) until appropriate porto-systemic flow established.

Stent deployment.

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