During TIPSS (transjugular intrahepatic portosystemic shunt) procedure, the stent is placed between which two hepatic structures?

• A Right hepatic vein and right portal vein branch ✓
• B Main portal vein and inferior vena cava
• C Hepatic artery and portal vein
• D Left hepatic vein and left portal vein branch

Explanation

TIPSS creates an intrahepatic channel between the hepatic venous system (typically the right hepatic vein) and the portal venous system (typically the right portal vein branch), providing a low-resistance portosystemic shunt to decompress portal hypertension. Access is via the jugular vein, advancing through the hepatic vein to the IVC, then puncturing through hepatic parenchyma into the portal vein. TIPSS is indicated for refractory variceal bleeding, refractory ascites, and hepatic hydrothorax. The gradient target is portal pressure <12 mmHg.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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