Gun-Sight, Not Shotgun, Nor Gun-Shot
To the Editor,
I enjoyed reading the recent article by Fitsiori et al.  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. . 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 . 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.