During a transjugular portosystemic stent-shunt (TIPSS) procedure a portal
vein laceration occurred with subsequent intraperitoneal hemorrhage. A PTFE
-covered nitinol stent was successfully placed eliminating the leak and cre
ating a functioning portosystemic shunt. This case demonstrates both the im
portance of portal vein puncture more than 1 cm from the bifurcation and th
e necessity of maintaining a stock of available stent-grafts.