Lewis Spencer B, Johnson Guy E, Valji Karim, Monroe Eric J, Ingraham Christopher R, Chick Jeffrey Forris Beecham, Shin David S
Division of Interventional Radiology, Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA.
Division of Interventional Radiology, Department of Radiology, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA, 9810, USA.
CVIR Endovasc. 2020 Oct 6;3(1):75. doi: 10.1186/s42155-020-00169-4.
Isolated persistent left superior vena cava (PLSVC) is a rare vascular anatomic variant, which can be an incidental finding at the time of an endovascular procedure.
This report describes the technical success, adverse events, and clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) creation via isolated PLSVC. Three adult patients with cirrhosis and isolated PLSVC underwent TIPS placement successfully with one major adverse event. Two patients required TIPS revision within 90 days. There were no deaths within 90 days.
TIPS creation via isolated PLSVC is feasible using standard techniques with a left jugular vein approach. Caution is warranted during the procedure to assess for any aberrant drainage pattern to the left atrium and to prepare for potentially challenging instrument navigation through the coronary sinus.
孤立性永存左上腔静脉（PLSVC）是一种罕见的血管解剖变异，可在血管内手术时偶然发现。
本报告描述了经孤立性PLSVC进行经颈静脉肝内门体分流术（TIPS）创建的技术成功情况、不良事件和临床结果。三名患有肝硬化和孤立性PLSVC的成年患者成功接受了TIPS植入，发生了一次主要不良事件。两名患者在90天内需要对TIPS进行修正。90天内无死亡病例。
采用标准技术经左颈静脉途径通过孤立性PLSVC创建TIPS是可行的。在手术过程中需谨慎评估是否存在异常的左心房引流模式，并为通过冠状窦进行潜在具有挑战性的器械导航做好准备。
