PMC4841896_01
A 43-year-old cirrhotic man with TIPS occlusion complicated with biliary fistula. Venogram through the right internal jugular access. Total occlusion was observed at the parenchymal segment of the TIPS tract (open arrow). Transjugular Intrahepatic Portosystemic Shunt-biliary fistula with contrast leakage to the common bile duct was delineated (black arrow).
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Venogram of the shunt revealed communication between the TIPS tract and the bile duct demonstrating a biliary-TIPS fistula combined with a focal stenosis of the stent at the hepatic venous segment of the TIPS tract (Figure 1).
Post-procedure portal venogram; the image shows the restoration of the shunt function after balloon angioplasty at the hepatic venous segment and an additional stent-graft. Transjugular intrahepatic portosystemic shunt-biliary fistula is no more visualized.
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Slow flow in the peripheral portal veins and the coronary veins were observed without residual stenosis (Figure 2).