Table 5.

Suggested approach to closure based on shunt type.

	One-stage	Two-stage
Intrahepatic CPSS	Endovascular (vascular plugs and coils)	Uncommon
Patent ductus venosus	Endovascular (vascular plugs; septal, duct and muscular occluders)	Uncommon
Extrahepatic side-to-side and end-to-side (from portal vein to inferior vena cava) CPSS	Endovascular (vascular plugs; septal, duct and muscular occluders, covered stents)Consider surgery if complex anatomy or wide and short shunt.	Surgical Consider endovascular with tailor-made devices if complex surgery or for the second procedure after surgical banding.
Extrahepatic CPSS upstream of portal vein	Endovascular (vascular plugs and coils, covered stents) In short shunts, consider surgery, especially in younger patients.	Surgical

CPSS, congenital portosystemic shunt(s).