Imaging and radiological interventions in extra-hepatic portal vein obstruction

Table 2 Various routes for gaining access to portal system during transjugular intra-hepatic portosystemic shunt in patients with extrahepatic portal vein obstruction

Route	Condition/preffered when
Transjugular	Routinely used
Transhepatic-IPVB is accessed using US guidance	Poor or non-visualization of MPV
Transsplenic-US guide puncture of SV	Failure of US guided puncture of IPVB
Trans-ileocolic-mini-laparotomy is required to gain access to ileal vein	Failure of all above routes
Trans-RPUV	In combination with above routes to delineate portal tree if LHV-RPUV junction is patent

IPVB: Intrahepatic portal vein branch; MPV: Main portal vein; US: Ultrasound; SV: Splenic vein; RPUV: Recanalised paraumbilical vein; LHV: Left hepatic vein.