Transjugular intrahepatic portosystemic shunt: Techniques for portal localization

Abstract

Finding and establishing access into the portal vein remains one of the more challenging aspects of transjugular intrahepatic portosystemic shunt (TIPS) procedures. Numerous methods to localize the portal vein have been described. Wedge venography remains the noninvasive technique that most consistently shows the portal vein anatomy. Attention to a few procedural details improves both the safety and efficacy of wedge venography. The full spectrum of invasive and noninvasive localization techniques are reviewed.