METHOD FOR TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTING Russian patent published in 2024 - IPC A61B17/00 A01B11/00 A61F2/82 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to endovascular surgery. Right hepatic vein is catheterised. Hepatic vein phlebography and portal vein carboxyphlebography are performed using a catheter in the right hepatic vein for administering a contrast agent. Catheter is replaced with an introducer. Stylet-catheter is delivered through an introducer, liver tissue and a right branch of the portal vein is punctured. Catheter is delivered into portal vein trunk. Intrahepatic passage is formed between the right hepatic vein and the right branch of the portal vein. Phlebography is performed with simultaneous contrast enhancement of vascular basins of hepatic and portal veins by introducing contrast into a portal vein trunk through a catheter installed in it and into a right hepatic vein through an introducer installed in it. Performed phlebography is used to determine the length of the formed intrahepatic passage, and a stent-graft equal in length to the formed intrahepatic passage is selected. First, a bare metal stent is implanted into the area of the formed intrahepatic passage, and then the stent-graft is implanted according to the “stent-graft-to-stent” principle. One end of the bare metal stent is placed in the trunk of the portal vein, and the other end of the bare metal stent is placed in the hepatic vein at 5 mm from the right wall of the inferior vena cava. Area of the stent-graft is limited by the boundaries of the formed intrahepatic passage.

EFFECT: method enables to prevent development of thrombosis of hepatic, portal veins and their branches, suprahepatic portal hypertension, hepatic encephalopathy; to expand technical capabilities of performing repeated liver interventions after TIPS.

3 cl, 1 ex