Management of a complex transjugular intrahepatic portosystemic shunt dysfunction with endotipsitis through rotational thrombectomy.
- Resource Type
- Report
- Authors
- Vizzutti F; Department of Experimental and Clinical Medicine, University of Florence, Florence I-50134, Italy.; Casamassima E; Interventional Radiology Unit, Department of Radiology, Careggi University Hospital, Florence I-50134, Italy.; Falcone G; Interventional Radiology Unit, Department of Radiology, Careggi University Hospital, Florence I-50134, Italy.; Gabbani G; Interventional Radiology Unit, Department of Radiology, Careggi University Hospital, Florence I-50134, Italy.; Rosi M; Department of Experimental and Clinical Medicine, University of Florence, Florence I-50134, Italy.; Adotti V; Department of Experimental and Clinical Medicine, University of Florence, Florence I-50134, Italy.; Marra F; Department of Experimental and Clinical Medicine, University of Florence, Florence I-50134, Italy.; Center for Research, High Education and Transfer DENOThe, University of Florence, Florence I-50134, Italy.; Fanelli F; Interventional Radiology Unit, Department of Radiology, Careggi University Hospital, Florence I-50134, Italy.
- Source
- Publisher: Oxford University Press Country of Publication: England NLM ID: 101684132 Publication Model: eCollection Cited Medium: Internet ISSN: 2055-7159 (Electronic) Linking ISSN: 20557159 NLM ISO Abbreviation: BJR Case Rep Subsets: PubMed not MEDLINE
- Subject
- Language
- English
Transjugular intrahepatic portosystemic shunting (TIPS) is an established strategy for the management of complications of portal hypertension. Endoprosthetic infection ("endotipsitis") is a rare but serious and difficult-to-treat complication of TIPS placement. Here we report the occurrence of an infected thrombus complicating TIPS placement in a patient with extra-hepatic portal vein obstruction, recurrent variceal bleeding and portal biliopathy accompanied by recurrent cholangitis. Infected thrombotic material within TIPS could be removed only by employing rotational thrombectomy. This procedure revealed the presence of a biliary fistula which carried pathogens in the systemic circulation. The multiple episodes of sepsis did no longer recur following exclusion of the biliary fistula. This case highlights the possibility to use rotational thrombectomy for the management of complex cases of TIPS dysfunction.
Competing Interests: FV, FM, and FF have received lecture fees from Gore.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the British Institute of Radiology.)