Transjugular intrahepatic portosystemic shunt for palliative treatment of portal hypertension secondary to portal vein tumor thrombosis

Figure 1 TIPS procedure in patient with incomplete occlusion of portal vein trunk. A: Main portal vein dilation with eccentric tumor thrombi shoven on enhanced Ctgram. B: Superior mesenteric vein dilation with eccentric filling defect and main portal vein occlusion shown on superior mesenteric vein angiogram. C: Open shunt shown on superior mesenteric vein angiogram after stent implantation. D: Recurrence of symptoms of ascites and diarrhoea 30 d after TIPS and shunt stenosis as wall as segmental filling defects shown on follow-up angiogram.

Figure 2 Occlusive portal vein, dialated superior mesenteric vein, portal vein cavernous transformation, and esophagogastric varices shown on portal vein angiogram after introducing a catheter into superior mesenteric vein.

Figure 3 Main portal vein occlusion, hepatic arteric portal shunt and portal cavernous transformation in a 64-year-old patient with refractory ascites and hematemesis. A: Thin splenic and superior mesenteric vein shown on enhanced CT gram. B: Thin superior mesenteric vein and disordered drainage vein shown on angiogram.