Transjugular intrahepatic portosystemic shunt for Budd-Chiari syndrome: A comprehensive review

Figure 1 Twenty-nine years old girl with Budd-Chiari syndrome and leiden factor V positive for heterozygote. A: Gadolinium-enhanced T1-weighted magnetic resonance image (MRI) obtained during arterial phase. Hyperintense structures represent portal venules, which are visible because of postsinusoidal portal hypertension; B: T2-weighted MRI shows hyperintensity ascites and splenomegaly; C: Using a Rösch-Uchida transjugular liver access set, a small collateral hepatic vein branch was accessed, the portal vein was punctured (D), and wire access into the superior mesenteric vein was achieved. A 10-mm diameter, 6-cm long Viatorr stent (W. L. Gore and Associates, Flagstaff, AZ, United States) was deployed, extending from the right portal vein to the inferior vena cava (E, F).