Utilization Of A Rotational Thrombectomy Catheter In Treatment Of A Thrombosed TIPS Stent Graft And Adjacent Portal Vein: A Single Case Study : Pharmacomechanical Thrombolysis and Thrombus Resolution In Difficult Access Structures

Trans jugular intrahepatic portosystemic shunt (TIPS) creation is a minimally-invasive procedure developed by Josef Rösch in 1971 to decompress the hepatic portal system to manage complications of portal hypertension by creating a conduit between the hepatic and portal vein to reduce portal venous pressure via shunting¹ Due to multiple factors with regards to the hepatic disease state and pressure gradients across the shunt, it is not uncommon to see these artificial shunts thrombose with studies demonstrating 10% thrombosis rates at 1-2 years² Due to the complexity and curvature of the vascular anatomy of the liver it can be challenging to treat TIPS stent graft thrombosis . This case study presents the utilization of a 7 French, 135cm rotational pharmacomechanical thrombectomy device to perform thrombectomy of a Viatorr stent graft (Gore Medical, Flagstaff, AZ, USA) and adjacent portal vein.