Systems and methods for assisting/performing image-guided transjugular intrahepatic portosystemic shunt (TIPS) procedures in a portion of an anatomy of a patient include a guide needle portion having a hollow tube with a bend toward its distal tip, and a puncture needle portion that includes at least one position indicating element at its tip. The puncture needle is slidably mounted within the hollow tube of the guide needle such that a distal tip of the puncture needle can be extended from an opening in the distal tip of the guide needle and used to place a shunt between the portal and hepatic veins of a patient. The position indicating element of the puncture needle is used to produce a display of the puncture needle relative to a target vessel, including a projected path of the puncture needle that can be adjusted to accurately locate a shunt.
