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Peribiliary cysts. Often misdiagnosed as biliary dilatation, biliary-IPMN or choledochal cysts. Are usually benign incidental findings in patients with cirrhosis (often with alcohol as the etiology) and severe portal hypertension. No active intervention required in most.

Portal vein aneurysm 38y/F, Incidentally detected extrahepatic saccular aneurysm just proximal to the bifurcation of main portal vein. No evidence of cirrhosis or portal hypertension. No history of trauma or pancreatitis. Kept on imaging surveillance.

Single session IVC plasty plus DIPS. 23y/F, chronic Budd Chiari syndrome, obliterated native hepatic veins with IVC web and thrombus. Refractory ascites. With SHOBS

lot of patients requiring Interventional Radiology treatments under Ayushman Bharat are being refused as we are told that those codes are still not implemented.Requesting Hon’ble Health Minister to kindly intervene Dr Mansukh Mandaviya Office of Dr Mansukh Mandaviya National Health Authority (NHA) PMO India ISVIR India

Consent ✅️ Herniated paraumbilical vein varix. 40y/M, CLD, 'epigastric hernia' containing convoluted and dilated paraumbilical vein, referred for embolisation due to increasing size and risk of inadvertent injury to the vein. With SHOBS and TheLiverDoc

"🔍 Ready to delve into the latest insights on IR management of portal hypertension? Join us at the upcoming ISVIR masterclass where Dr. Rajesh Sasidharan will unravel key strategies and advancements in managing this complex condition. #ISVIR #JUNIORWING #MASTERCLASS #PORTAL

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 Sudheer Pargewar

CARTO for ectopic variceal bleeding. 70y/F, Cirrhosis, Upper GI bleeding Imaging - Dual afferents from superior mesenteric vein feeding duodenal varices with a single outflow into IVC. Coil-assisted retrograde occlusion of shunt and varices. With Sudheer Pargewar

Hepatic vein stenting for Budd Chiari syndrome. 44y/M with ascites. Normalisation of hepatic enhancement merely 2 days after stenting. Middle and left hepatic veins start draining through collaterals into the stent. Ascites ⬇️. With SHOBS, Akhil Baby and TheLiverDoc

Subcapsular splenic hematoma ⬅️ pseudoaneurysm ⬅️ pancreatitis. Drainage f/b front and back door coil embolisation of parent artery. PSA starts filling from gastroepiploic artery🤯 Percutaneous trans-splenic glue embolisation to the rescue. With SHOBS and Akhil Baby

‘Vampire bite’ jugular access for occluding dual efferents of lienorenal shunt. 62 year old gentleman with recurrent severe hepatic encephalopathy. With SHOBS, Akhil Baby and TheLiverDoc

Right-to-left TIPS in variant portal venous anatomy. Nakamura type D. No suitable angle from RHV to any of the RPV branches. At the risk of going extrahepatic, single-wall puncture of meandering LPV trunk done under USG guidance. With SHOBS, Akhil Baby, TheLiverDoc

PVR-TIPS for refractory ascites. 71 y/F, NASH-cirrhosis. On weekly LVP. CT - Thrombosed main portal vein and its right and left branches. Ultrasound guided transjugular puncture of the thrombosed right portal vein done for TIPS. With SHOBS, Akhil Baby, TheLiverDoc

Thrilled to announce the launch of our fellowship program in Hepatobiliary Interventional Radiology at the Center of Excellence in GI Sciences at Rajagiri Hospital, Kochi, Kerala. More details in the poster below.

40y/F, Polycythemia, BCS High SAAG, low protein ascites Bilirubin 3.1 All hepatic veins thrombosed. Segment 7 vein partly patent (angio below) WWYD? 1. Anticoagulation 2. HV thrombolysis/stenting 3. TIPS/DIPS 4. Liver Transplant 5. Need more info/investigations (specify)

Spontaneous necrosis of HCC 76y/M, Solitary HCC, planned for TACE. Presented with fatigue and abdominal discomfort 2 days prior to scheduled procedure. Bilirubin ⬆️ from 1.2 to 11, ALP & GGT raised. Imaging repeated to rule out any obstructive biliary pathology. TheLiverDoc

Persistence of portosystemic shunt and varices post TIPS and transplant with post LT bleed. 57y/M, CLD, recurrent bleed. TIPS - 2022. Coronary vein blocked with TIPS. 2024 - HCC. Patent TIPS. Persistent coronary. Underwent LT. 6th POD - Variceal bleed. Banded. Thoughts?

48 yo man, alcohol associated liver disease. Focal lesion in segment 4 wrapping around GB fossa in an inverted V shape. CT - Arterial enhancement. No convincing washout. MRI - T2 hypo, T1 hyper, no diffusion restriction, washout +. Subtraction images not available. Thoughts?

Parallel guidewire anchoring technique for cannulating a blocked TIPS stent.

Inviting applications for our Hepatobiliary Interventional Radiology Fellowship. Last date for submitting applications - 15th June, 2025 Course commencement - 1st July, 2025 Send your CV to - [email protected]