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CVIR Endovascular
Fig. 2 | CVIR Endovascular

Fig. 2

From: Successful direct intrahepatic portosystemic shunt (DIPS) creation following transmesenteric porta hepatis access in a young patient with recurrent variceal bleeding

Fig. 2

Digital subtraction images from procedure show (a) contrast in the hepatic artery via a 21G needle placed under ultrasound access (black arrow). b This access was used as a landmark to place a second 21G needle under fluoroscopic guidance into the portal system confirmed with contrast injection. c A 21G needle was used under fluoroscopy to puncture the SMV collateral from the IVC and a 1.5F support catheter (white dashed arrows) was navigated across the parenchymal tract into the portal system confirmed via contrast injection

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