MesoTIPS: Combined approach for the treatment of portal hypertension secondary to portal vein thrombosis – A brief report

• Main Authors: Abbas Chamsuddin, Lama Nazzal, Thomas Heffron, Osama Gaber, Raja Achou, Louis G Martin
• Format: Article
• Language: English
• Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2017-01-01
• Series: The Arab Journal of Interventional Radiology
• Subjects: Meso-transjugular intrahepatic portosystemic shunt; portal hypertension; portal vein thrombosis; transjugular intrahepatic portosystemic shunt
• Online Access: http://www.arabjir.com/article.asp?issn=2542-7075;year=2017;volume=1;issue=1;spage=20;epage=26;aulast=Chamsuddin

Introduction: We describe a technique we call “Meso-transjugular intrahepatic portosystemic shunt (MTIPS)” for relief of portal hypertension secondary to portal vein thrombosis (PVT) using combined surgical and endovascular technique. Materials and Methods: Nine adult patients with PVT underwent transjugular intrahepatic portosystemic shunt through a combined transjugular and mesenteric approach (MTIPS), in which a peripheral mesenteric vein was exposed through a minilaparotomy approach. The right hepatic vein was accessed through a transjugular approach. Mechanical thrombectomy, thrombolysis, and angioplasty were performed when feasible to clear PVT. Results: All patients had technically successful procedures. Patients were followed up for a mean time of 13.3 months (range: 8 days to 3 years). All patients are still alive and asymptomatic. Conclusion: We conclude that MTIPS is effective for the relief of portal hypertension secondary to PVT.