Transjugular

Transjugular refers to procedures or approaches that access the body through the jugular vein, most commonly the internal jugular vein. This route is used when central venous access or navigation to hepatic, portal, cardiac, or thoracic vascular structures is required. Transjugular techniques are performed by interventional radiologists and related specialties and are chosen to maximize safety in patients with difficult anatomy or higher bleeding risk.

Two of the most well-known transjugular procedures are transjugular intrahepatic portosystemic shunt (TIPS) and transjugular liver biopsy. TIPS is a catheter-based intervention that creates a channel within the liver to connect a hepatic vein with a branch of the portal vein, reducing portal hypertension. It is typically indicated for refractory ascites or variceal bleeding in cirrhosis when medical therapy fails. The procedure proceeds via the internal jugular vein, often requiring imaging guidance and stent placement. Transjugular liver biopsy uses a needle introduced through the jugular pathway to obtain liver tissue, offering an alternative to percutaneous biopsy in patients with ascites, coagulopathy, or other contraindications to external puncture.

Other transjugular techniques include venography and catheter-based diagnostic or therapeutic maneuvers performed through the jugular system. Advantages of transjugular access include favorable control of bleeding risk in certain patients, while complications may involve bleeding, infection, thrombosis, or device malfunction.

In summary, transjugular denotes jugular vein–based access for diagnostic and therapeutic vascular and hepatic procedures, with TIPS and transjugular biopsy as principal examples.