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Semin intervent Radiol 2023; 40(03): 269-273
DOI: 10.1055/s-0043-1769772
Review Article

Viatorr Stent Migration and Retrieval during Transjugular Intrahepatic Portosystemic Shunt Revision

Stephanie H. Kim
1   Division of Vascular and Interventional Radiology, Department of Radiology, University of Cincinnati, Cincinnati, Ohio
,
Michael Samuel
1   Division of Vascular and Interventional Radiology, Department of Radiology, University of Cincinnati, Cincinnati, Ohio
,
Abouelmagd Makramalla
1   Division of Vascular and Interventional Radiology, Department of Radiology, University of Cincinnati, Cincinnati, Ohio
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Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) is an important interventional option for the treatment of complications related to cirrhosis and portal hypertension. Emergent TIPS placement can be a life-saving measure in patients with uncontrolled variceal hemorrhage. After TIPS placement, patients may benefit from additional interventions for clinical optimization including stent dilation, stent extension, and embolization of varices. Here, we describe a case of emergent TIPS placement and revision which resulted in TIPS stent migration requiring stent removal and replacement. We discuss our technique and review previously reported methods for the management of migrated TIPS stents.

Keywords

interventional radiology - transjugular intrahepatic portosystemic shunt - foreign body retrieval - Viatorr


Publication History

Article published online:
20 July 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Pandhi MB, Kuei AJ, Lipnik AJ, Gaba RC. Emergent transjugular intrahepatic portosystemic shunt creation in acute variceal bleeding. Semin Intervent Radiol 2020; 37 (01) 3-13
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Monescillo A, Martínez-Lagares F, Ruiz-del-Arbol L. et al. Influence of portal hypertension and its early decompression by TIPS placement on the outcome of variceal bleeding. Hepatology 2004; 40 (04) 793-801
    CrossrefPubMedGoogle Scholar
  • 3 García-Pagán JC, Caca K, Bureau C. et al; Early TIPS (Transjugular Intrahepatic Portosystemic Shunt) Cooperative Study Group. Early use of TIPS in patients with cirrhosis and variceal bleeding. N Engl J Med 2010; 362 (25) 2370-2379
    CrossrefPubMedGoogle Scholar
  • 4 Garcia-Pagán JC, Di Pascoli M, Caca K. et al. Use of early-TIPS for high-risk variceal bleeding: results of a post-RCT surveillance study. J Hepatol 2013; 58 (01) 45-50
    CrossrefPubMedGoogle Scholar
  • 5 Ripamonti R, Ferral H, Alonzo M, Patel NH. Transjugular intrahepatic portosystemic shunt-related complications and practical solutions. Semin Intervent Radiol 2006; 23 (02) 165-176
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Ray MJ, Savage C, Klintmalm GB, Rees CR. Endovascular caudal retraction of the cranial end of a misplaced Viatorr TIPS prior to liver transplantation. Proc Bayl Univ Med Cent 2012; 25 (04) 341-343
    CrossrefPubMedGoogle Scholar
  • 7 Suhocki PV, Lungren MP, Kapoor B, Kim CY. Transjugular intrahepatic portosystemic shunt complications: prevention and management. Semin Intervent Radiol 2015; 32 (02) 123-132
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Richter GM, Noeldge G, Palmaz JC. et al. Transjugular intrahepatic portacaval stent shunt: preliminary clinical results. Radiology 1990; 174 (3, Pt 2): 1027-1030
    CrossrefPubMedGoogle Scholar
  • 9 Cejna M, Peck-Radosavljevic M, Thurnher SA, Hittmair K, Schoder M, Lammer J. Creation of transjugular intrahepatic portosystemic shunts with stent-grafts: initial experiences with a polytetrafluoroethylene-covered nitinol endoprosthesis. Radiology 2001; 221 (02) 437-446
    CrossrefPubMedGoogle Scholar
  • 10 Charon JP, Alaeddin FH, Pimpalwar SA. et al. Results of a retrospective multicenter trial of the Viatorr expanded polytetrafluoroethylene-covered stent-graft for transjugular intrahepatic portosystemic shunt creation. J Vasc Interv Radiol 2004; 15 (11) 1219-1230
    CrossrefPubMedGoogle Scholar
  • 11 Cohen GS, Ball DS. Delayed Wallstent migration after a transjugular intrahepatic portosystemic shunt procedure: relocation with a loop snare. J Vasc Interv Radiol 1993; 4 (04) 561-563
    CrossrefPubMedGoogle Scholar
  • 12 Slonim SM, Dake MD, Razavi MK. et al. Management of misplaced or migrated endovascular stents. J Vasc Interv Radiol 1999; 10 (07) 851-859
    CrossrefPubMedGoogle Scholar
  • 13 Mirchia K, Thibodeau R, Goel A. et al. A successful endovascular repositioning of migrated transjugular intrahepatic portosystemic shunt (TIPS) stent. Radiol Case Rep 2020; 16 (02) 278-283
    CrossrefPubMedGoogle Scholar
  • 14 McGregor H, Brunson C, Woodhead G, Patel MV, Hennemeyer C. Caudal migration and endovascular retrieval of two VIATORR CX stent grafts during transjugular intrahepatic portosystemic shunt placement. J Vasc Interv Radiol 2020; 31 (03) 512-515
    CrossrefPubMedGoogle Scholar
  • 15 Cwikiel W, Bergenfeldt M, Keussen I. Endovascular removal of the Viatorr stent-grafts: report of two cases. Pol J Radiol 2015; 80: 277-280
    CrossrefPubMedGoogle Scholar