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Fig. 1 | BMC Gastroenterology

Fig. 1

From: Transjugular intrahepatic portosystemic shunt for hepatic sinusoidal obstruction syndrome associated with consumption of Gynura segetum

Fig. 1

TIPS procedures for GS-related HSOS. a Right hepatic venogram through a catheter positioned in the right hepatic vein showed the relationship of the right hepatic vein (arrowhead) with the right portal vein (vertical arrow) and portal vein trunk (horizontal arrow) into which a 0.014-in guide wire was percutaneously inserted. b Puncture of the right portal vein with a Rösch-Uchida TIPS needle (arrow). c Portogram through a calibrated pigtail catheter positioned in the splenic vein confirmed the successful access to the portal vein. Note the persistent opacification of the gastroesophageal varices (arrow) due to the portal hypertension. d Dilatation of the parenchymal tract with a 6-mm-diameter balloon. e Deploying a bare stent and subsequently a covered stent inside the bare stent across the portosystemic tract. Distending the stents to an 8 mm diameter if necessary. f Post-TIPS portogram demonstrated flow through the TIPS shunt, with no opacification of any gastroesophageal varices

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