Fig. 1

A middle-aged man with end-stage liver disease, portal hypertension, colovesical fistula, and isolated persistent left superior vena cava. a Left internal jugular venography demonstrating the isolated persistent left superior vena cava (solid arrow). b Wedged portal venography using an occlusion balloon (solid arrow). c The right portal vein was accessed using a Rösch-Uchida needle, and portal venography was performed. A 12-mm × 6-cm (covered) / 2-cm (uncovered) Viatorr stent-graft was deployed. Post-deployment portal venography; however, showed limited flow. d After Viatorr stent-graft (solid arrow) deployment, an additional 12-mm × 6-cm Wallstent (dashed arrow) was placed to extend the portal aspect of the construct, resulting in brisk in-line flow