EURORAD ESR

Case 15845

Tackling a thrombosed TIPSS

Author(s)
DR. SHREYA SHUKLA1, M.B.B.S
DR. SABA SHAIKH2, M.B.B.S, D.N.B.
DR. CHITRANGADA SINGH3, M.B.B.S, M.D.

JASLOK HOSPITAL AND RESEARCH CENTRE; 15, Dr. Deshmukh Marg, Pedder Road, Mumbai, Maharashtra 400026 400026 India, India; Email:drshreyashukla@gmail.com
 
Patient
female, 20 year(s)
 
 
  • Figure 1
    Thrombotic occlusion of TIPS stent

    Color Doppler image showing absent color flow within TIPS stent suggestive of thrombotic occlusion (Fig. 1)

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Complications; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 2
    Thrombotic occlusion of portomesenteric stent

    Color Doppler image showing absent color flows in portomesenteric stent suggestive of thrombotic occlusion. Collaterals are noted around the stent (Fig. 2)

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Stents; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 3
    Occluded TIPSS stent

    TIPSS venogram showing complete occlusion of the stent (Fig. 3)

     
    Area of Interest: Interventional vascular; Imaging Technique: Catheter venography; Procedure: Recanalisation; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 4
    Fluroguided Balloon angioplasty

    Fluoroguided access through right internal jugular vein done. Using catheter guide wire combination, TIPSS stent negotiated and balloon angioplasty done using 10 X 40 mm balloon (Fig. 4)

     
    Area of Interest: Portal system / Hepatic veins; Imaging Technique: Fluoroscopy; Procedure: Recanalisation; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 5
    Recanalised Stent

    TIPSS venogram revealing good flow across stent post angioplasty and chemical thrombolysis (Fig. 5)

     
    Area of Interest: Interventional vascular; Imaging Technique: Catheter venography; Procedure: Recanalisation; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 6
    Patent TIPSS stent post balloon angioplasty

    Ultrasound images showing patent lumen of TIPS stent on B mode and wall to wall filling on Colour Doppler, post balloon angioplasty and thrombolysis (Fig. 6)

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Stents; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 7
    TIPSS stent- IVC end

    Ultrasound - Spectral doppler of TIPS stent showing normal flows post balloon angioplasty and chemical thrombolysis (Fig. 7)

     
    Area of Interest: Portal system / Hepatic veins; Imaging Technique: Ultrasound-Spectral Doppler; Procedure: Angioplasty; Special Focus: Embolism / Thrombosis;
     
     
  • Figure 8
    Normal flows in Portomesenteric stent following balloon angioplasty

    Ultrasound- Spectral doppler showing normal flows in Porto-mesenteric stent following balloon angioplasty and chemical thrombolysis (Fig 8.)

     
    Area of Interest: Portal system / Hepatic veins; Imaging Technique: Ultrasound-Spectral Doppler; Procedure: Recanalisation; Special Focus: Embolism / Thrombosis;
     
     
Color Doppler image showing absent color flow within TIPS stent suggestive of thrombotic occlusion (Fig. 1)
 
Color Doppler image showing absent color flows in portomesenteric stent suggestive of thrombotic occlusion. Collaterals are noted around the stent (Fig. 2)
 
TIPSS venogram showing complete occlusion of the stent (Fig. 3)
 
Fluoroguided access through right internal jugular vein done. Using catheter guide wire combination, TIPSS stent negotiated and balloon angioplasty done using 10 X 40 mm balloon (Fig. 4)
 
TIPSS venogram revealing good flow across stent post angioplasty and chemical thrombolysis (Fig. 5)
 
Ultrasound images showing patent lumen of TIPS stent on B mode and wall to wall filling on Colour Doppler, post balloon angioplasty and thrombolysis (Fig. 6)
 
Ultrasound - Spectral doppler of TIPS stent showing normal flows post balloon angioplasty and chemical thrombolysis (Fig. 7)
 
Ultrasound- Spectral doppler showing normal flows in Porto-mesenteric stent following balloon angioplasty and chemical thrombolysis (Fig 8.)
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version