{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T10:03:24Z","timestamp":1779703404487,"version":"3.53.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012352","name":"Universit\u00e0 degli Studi di Milano","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012352","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiol med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a well-established procedure for managing portal hypertension and its complications that are refractory to medical and endoscopic therapy. However, complex cases may render the conventional approach ineffective. We describe the cross-sight (CS) technique, which combines ultrasound and fluoroscopic guidance to allow simultaneous puncture of the hepatic and portal veins through a single transhepatic needle pass. Following portal access, stent graft deployment is performed via the jugular route, while the percutaneous tract is closed with a vascular plug to minimize bleeding risk. In our experience, this approach enabled safe and effective shunt creation after failed standard TIPS, with no procedure-related complications. The CS technique provides enhanced procedural control and avoids the limitations of alternative strategies such as DIPS or gun-sight methods. By reducing puncture attempts and access points, it represents a feasible salvage option for complex TIPS cases, with potential immediate application in interventional radiology practice.<\/jats:p>","DOI":"10.1007\/s11547-026-02175-3","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T08:01:45Z","timestamp":1769500905000},"page":"820-825","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross-sight transjugular intrahepatic portosystemic shunt (CS-TIPS): combined ultrasound-fluoroscopy guidance for simultaneous percutaneous portal and hepatic vein puncture and access closure with plug deployment"],"prefix":"10.1007","volume":"131","author":[{"given":"Maria Giovanna","family":"Riga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Triggiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sveva","family":"Mortellaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore Alessio","family":"Angileri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Ierardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone Raoul","family":"Mortellaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpaolo","family":"Carrafiello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"issue":"3","key":"2175_CR1","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1056\/NEJM199401203300303","volume":"330","author":"M R\u00f6ssle","year":"1994","unstructured":"R\u00f6ssle M (1994) The transjugular intrahepatic portosystemic stent-shunt procedure for variceal bleeding. 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