In Reply to: Re: Case 0400_07 -- TIPS Shunt Creation With Chronic Portal Vein Occlusion posted by Moni Stein on April 10, 2000 at 11:53:05:
As of approximately 3 mo post-op no re bleeding and the ascites has disappeared .I have to admit this issue that you raise was and continues to be of concern.Admittedly I hadn't considered the method you used in the case you presented last month though it may also have been a viable option. The case report reference that I sited (JVIR 1999; 10:575- 578) followed there patient for 6 mo with no recurrent bleeding.Additionally this patients PV was occluded for quite some time (attempted TIPS at another institution that failed 1yr earlier revealed the same findings) and may not have been recanalizable. Furthermore when the independently accessed PV cavernous collaterals were injected after completion of the TIPS outflow from these veins flowed through the shunt as was noted on figure 4. However, this is certainly unchartered territory .