Intravascular Ultrasound in the Creation of Transhepatic Portosystemic Shunts Reduces Needle Passes, Radiation Dose, and Procedure Time: A Retrospective Study of a Single-Institution Experience

Kao, Steven D.; Morshedi, Maud M.; Narsinh, Kazim; Kinney, Thomas B.; Minocha, Jeet; Picel, Andrew C.; Newton, Isabel G.; Rose, Steven C.; Roberts, Anne C.; Kuo, Alexander; Aryafar, Hamed

doi:10.1016/j.jvir.2016.01.137

Cited by 50 publications

(31 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Doppler imaging may be prudent to ensure portal venous patency in individuals who cannot undergo CT or MR imaging. As a final note, use of intravascular ultrasound guidance for TIPS creation[111213] provides an additional means for IR operators to identify and target portal vein branches during TIPS procedures and may render some of the more challenging anatomic cases technically easier given the ability to visualize and puncture vessels with real-time observation.…”

Section: Discussionmentioning

confidence: 99%

Anatomic Variations of the Right Portal Vein: Prevalence, Imaging Features, and Implications for Successful Transjugular Intrahepatic Portosystemic Shunt Creation

Gunasekaran

Gaba

2017

Journal of Clinical Imaging Science

View full text Add to dashboard Cite

Given the widespread use of transjugular intrahepatic portosystemic shunt (TIPS) creation for the treatment of portal hypertensive complications, a working knowledge of portal venous anatomy is critical for interventional radiologists. The right portal vein – which is most commonly accessed during TIPS – is subject to various anatomic variants that may potentially impact procedure success. This pictorial essay characterizes the anatomic patterns of the right portal vein branching in terms of type and frequency based on case series review. The work also explains the potential procedural implications of the right portal vein anatomic variations as they pertain to TIPS technical success.

show abstract

Section: Discussionmentioning

confidence: 99%

Anatomic Variations of the Right Portal Vein: Prevalence, Imaging Features, and Implications for Successful Transjugular Intrahepatic Portosystemic Shunt Creation

Gunasekaran

Gaba

2017

Journal of Clinical Imaging Science

View full text Add to dashboard Cite

show abstract

“…Due to the limited visualization provided by traditional two dimensional fluoroscopy systems, TIPS may often involve several needle punctures, and up to 35 needle punctures in a single procedure have been reported. 7 Hepatic arterial and other non-target organ puncture ( Fig. 1) has been described to occur in 1% to 6% of all TIPS cases.…”

Section: Portal Venous Accessmentioning

confidence: 99%

A review of recent experience with transjugular intrahepatic portosystemic shunt creation using intravascular ultrasound

Kao

Lee

2018

Int J Gastrointest Interv

Self Cite

View full text Add to dashboard Cite

Portal vein access has historically been the most technically challenging step in the creation of transjugular intrahepatic portosystemic shunts (TIPSs). The use of intravascular ultrasound (IVUS) for guidance of portal vein access during TIPS creation has garnered much interest in recent years. Recent literature has suggested potential improvements in procedural metrics that may result from use of IVUS for TIPS. This review aims to provide historical context, detail technical advances and describe recent clinical experience with the use of IVUS for TIPS creation.

show abstract

“…81,83,87,88 Factors contributing to the increased radiation dose in the patient where the estimated fetal dose was 54.0 mGy were threefold: multiple passes needed to access the portal system, the need to place two stents, and the need to embolize large, persistent gastric varices after TIPS placement. 81 As such, the use of additional imaging guidance, including intravascular or transabdominal ultrasound 89 and imaging fusion with overlay, should be considered, as it can decrease the number of attempts required to access the portal system and decrease the use of fluoroscopy during the procedure. Other strategies to decrease radiation dose include decreasing the fluoroscopy pulse rate and frame rate, and collimating to the area of interest.…”

Section: Pregnancymentioning

confidence: 99%

Transjugular Intrahepatic Portosystemic Shunts in High-Risk Patients

Shin

Johnson

et al. 2020

Digestive Disease Interventions

View full text Add to dashboard Cite

Cirrhosis with complications of portal hypertension portends a poor prognosis. Transjugular intrahepatic portosystemic shunts (TIPS) can successfully treat some of these complications in select patients. While the safety and efficacy of TIPS have improved significantly over the past decade, certain patients are categorized as high-risk based on various demographic, laboratory, and comorbid factors. Herein, we provide an in-depth review of TIPS in these settings, including high model for end-stage liver disease score, hepatic malignancy, advanced age, cardiac disease, renal dysfunction, and pregnancy, and discuss their impact on patient selection and procedural considerations.

show abstract

Intravascular Ultrasound in the Creation of Transhepatic Portosystemic Shunts Reduces Needle Passes, Radiation Dose, and Procedure Time: A Retrospective Study of a Single-Institution Experience

Cited by 50 publications

References 20 publications

Anatomic Variations of the Right Portal Vein: Prevalence, Imaging Features, and Implications for Successful Transjugular Intrahepatic Portosystemic Shunt Creation

Anatomic Variations of the Right Portal Vein: Prevalence, Imaging Features, and Implications for Successful Transjugular Intrahepatic Portosystemic Shunt Creation

A review of recent experience with transjugular intrahepatic portosystemic shunt creation using intravascular ultrasound

Transjugular Intrahepatic Portosystemic Shunts in High-Risk Patients

Contact Info

Product

Resources

About