Portocaval shunts using gunsight technique in patients with portal vein thrombosis after unsuccessful portal vein recanalization

After unsuccessful transjugular intrahepatic portosystemic shunt placement in patients with portal hypertension a direct portosystemic shunt can be created via an approachable method deemed the "gunsight" technique.This technique involves utilizing snares within the target vessels to align a direct route and allow for creation of a connection via stent-graft.This decreases the portosystemic gradient and can lead to improvements in ascites and variceal bleeding.This case series aims to detail the aforementioned technique to create mesocaval shunts in three patients.