case_images: PMC10873906_01
case_images: (A) Contrast enhanced CT scan, venous phase, showing cavernomatous transformation of extra-hepatic portal vein and portal biliopathy. (B) Catheterization of the native portal vein by a combined percutaneous trans-jugular intra-hepatic and trans-splenic approach. (C) Final phlebography at TIPS positioning.
case_images: uaae005f1.jpg
case_images: PMC10873906_01_uaae005f1.jpg
case_images: uaae005-F1
case_images: TIPS placement as secondary prophylaxis of variceal bleeding (Figure 1A). Under ultrasound guidance, a landing intra-hepatic PV branch was reached by percutaneous trans-jugular intrahepatic approach, and the native PV trunk was catheterized by combining a trans-splenic approach to assist with the recanalization of the portal venous system (Figure 1B). The portacaval pressure gradient (PCG) dropped (12 vs. 27 mmHg) following 10 mm balloon dilation (Figure 1C).