Fig. 1. A 55-year-old female patient presenting with ascites. Model for end-stage liver disease (MELD) score of 16 and Rotterdam score of 1.16 (Class 2). Web-like occlusion in the suprahepatic inferior venecava (IVC) (arrow; A). Right and middle hepatic veins were draining into the IVC distal to occlusion (not in image). Left hepatic vein was draining into IVC below occlusion (arrowhead; B). Through transfemoral approach the Rosch-Uschida set was positioned with the tip at the level of the web (arrow; B). The web was punctured by the inner trocar-catheter combination (arrow; C) and crossed (arrow; D). Note the contrast in the right atrium (arrow; E). Angioplasty performed using an 18mm balloon (arrow; F). Post-angioplasty angiogram shows the free flow of contrast across previous occluded segment (arrow; G) with no pressure gradient.
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