Two Budd chiari back to back
All three hepatic veins gone [ acute on chronic)
First -Factor 5 Leiden mutation
Second- Protien C, S deficiency
Impending liver failure
Emergency DIPS
# interventional radiology
Transabdominal USG-guided left to left TIPS - step by step guide.
Cannulate LHV ➡️ Insert RUPS over wire ➡️ USG probe in midsagittal plane in epigastrium ➡️ rotate stiffening cannula to bring it in the same plane as USG probe ➡️ PV puncture ➡️ stenting
With @SudheerPargewar
Post Ldlt hj stricture with impacted stone /biliary cast
Dilated with ballon...pushed into jejunum ...coronary balloon used to clean anterior duct
Satisfactory final results...
Another renal bleed ..
Ruptured aneurysm with large hematoma...hypotension ..patient dipping
Endovascular coiling ....
Stealing of blood into aneurysmal sac blunted ...parenchymal vascularity increased hope patient will require less antihypertensive in future...
Biodegradable biliary stent ...
Reality or myth
Excellent result in post Ldlt anastamotic stricture..first hands-on experience...@ISVIRIndia@fortis_hospital