PMC2648948_01
A. Narrowed IVC with non visualization of hepatic veins. B. IVC stent in situ.
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F1
The hepatic veins could not be cannulated, suggestive of complete occlusion at the ostia. (Figure 1:A). An 18 x 63 mm WALL STENT was placed across the narrowed segment in the IVC followed by balloon dilatation using a 16 mm balloon (Figure 1:B).
Percutaneous transhepatic venogram revealed left hepatic vein replaced by multiple collaterals, IVC stent in situ.
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F2
IVC stent was in situ (Figure 2).
Transjugular venogram A. Patent IVC Stent B. Narrowed portocaval graft.
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F3
There was narrowing of the portosystemic graft with a gradient of more than 15 mmHg near its IVC end (Figure 3:A, B).
Transfemoral venoplasty A. Pre dilatation of the graft. B. Widened, patent graft post dilatation with stent in situ.
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F4
Following predilatation of the graft with a 5 mm angioplasty balloon (Figure 4A), an 8 mm x 30 mm self-expanding nitinol stent was placed in the graft covering its portal and caval ends. Post stenting portal venogram showed good flow through the graft into the IVC (Figure 4:B).