The Role of Interventional Radiology in Treating Complications following Liver Transplantation
(a) A TIPS procedure in a liver transplant. A direct transhepatic puncture of the portal vein is initially performed. Contrast is injected through the needle to confirm the position. (b) A further puncture through the wall of the left portal vein into the hepatic vein is performed. A wire is passed up into the SVC, and a transjugular catheter is then advanced over the wire after it has been snared. (c) The remainder of the TIPS procedure is now performed via the routine transjugular approach. The track between the portal vein and hepatic vein is dilated with a balloon. (d) The TIPS stent is placed in situ, and contrast is injected into the portal vein to confirm flow through the stent and into the hepatic vein.
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