CardioVascular and Interventional Radiology

, Volume 37, Issue 6, pp 1635–1635 | Cite as

Gun-Sight, Not Shotgun, Nor Gun-Shot



Public Health Nuclear Medicine Hepatic Vein Recent Article Actual Description 
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To the Editor,

I enjoyed reading the recent article by Fitsiori et al. [1] regarding the use of TIPS in Budd Chiari patients. I am writing to provide one historical clarification for the readers, should they seek the actual description for performing this technique. Within this research, the authors describe treating one patient using the “shotgun” technique, referencing an excellent 2004 report by Bilbao et al. [2]. Within the latter, that technique was described as the “gun-shot” technique. The actual name of this technique is “gun-sight approach,” a term that I coined to describe the use of overlapping snares to perform a through-and-through puncture of portal and hepatic veins to create a transcaval portosystemic shunt [3]. That being said, in the majority of cases since that report, I perform a direct transcaval puncture using a coaxial skinny needle through the larger “conventional” Colapinto needle, for these patients.


Conflict of interest

Dr. Haskal reports personal fees from Cook Medical, outside the submitted work.


  1. 1.
    Fitsiori K, Tsitskari M, Kelekis A, Filippiadis D, Triantafyllou K, Brountzos E (2014) Transjugular intrahepatic portosystemic shunt for the treatment of Budd-Chiari syndrome patients: results from a single center. Cardiovasc Intervent Radiol 37(3):691–697PubMedCrossRefGoogle Scholar
  2. 2.
    Bilbao JI, Elorz M, Vivas I, Martínez-Cuesta A, Bastarrika G, Benito A (2004) Transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of venous symptomatic chronic portal thrombosis in non-cirrhotic patients. Cardiovasc Intervent Radiol 27(5):474–480PubMedGoogle Scholar
  3. 3.
    Haskal ZJ, Duszak R Jr, Furth EE (1996) Transjugular intrahepatic transcaval portosystemic shunt: the gun-sight approach. J Vasc Interv Radiol 7(1):139–142PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2014

Authors and Affiliations

  1. 1.Division of Interventional RadiologyUniversity of Virginia School of MedicineCharlottesvilleUSA

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