ArticleLa Radiologia medica2026
Cross-sight transjugular intrahepatic portosystemic shunt (CS-TIPS): combined ultrasound-fluoroscopy guidance for simultaneous percutaneous portal and hepatic vein puncture and access closure with plug deployment.
Article in La Radiologia medica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a well-established procedure for managing portal hypertension and its complications that are refractory to medical and endoscopic therapy. However, complex cases may render the conventional approach ineffective. We describe the cross-sight (CS) technique, which combines ultrasound and fluoroscopic guidance to allow simultaneous puncture of the hepatic and portal veins through a single transhepatic needle pass. Following portal access, stent graft deployment is performed via the jugular route, while the percutaneous tract is closed with a vascular plug to minimize bleeding risk. In our experience, this approach enabled safe and effective shunt creation after failed standard TIPS, with no procedure-related complications. The CS technique provides enhanced procedural control and avoids the limitations of alternative strategies such as DIPS or gun-sight methods. By reducing puncture attempts and access points, it represents a feasible salvage option for complex TIPS cases, with potential immediate application in interventional radiology practice.
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