Fig. 2. Plug-assisted retrograde transvenous obliteration. (A) A venogram obtained from a 5-Fr catheter revealed a giant high-flow gastrorenal shunt (GRS) (arrow) with two aneurysmal segments separated by a waist. (B) A 10-Fr long sheath (arrowheads) was secured at the upper dilated segment. (C) A 22-mm Amplatzer Vascular Plug (AVP) was positioned within the GRS so that the middle lobe was anchored at the waist. (D) The final venogram through the sheath confirmed a complete occlusion of the GRS while leaving the renal venous outflow patent.
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