TY - JOUR
T1 - Utility of Intravascular US–Guided Portal Vein Access during Transjugular Intrahepatic Portosystemic Shunt Creation
T2 - Retrospective Comparison with Conventional Technique in 109 Patients
AU - Pillai, Anil K.
AU - Andring, Brice
AU - Faulconer, Nicholas
AU - Reis, Stephen P.
AU - Xi, Yin
AU - Iyamu, Ikponmwosa
AU - Suthpin, Patrick D.
AU - Kalva, Sanjeeva P.
N1 - Publisher Copyright:
© 2016 SIR
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Purpose To compare safety and effectiveness of intravascular ultrasound (US)–guided portal vein access during transjugular intrahepatic portosystemic shunt (TIPS) creation with conventional TIPS technique. Materials and Methods In this retrospective study, TIPS creation using intravascular US guidance in 55 patients was compared with conventional TIPS creation in 54 patients by 10 operators over a 3-year period. Operators were classified as experienced if they had performed ≥ 20 TIPS procedures at the beginning of the study period. Time to portal vein access, total radiation dose, and needle pass–related capsular perforation were recorded. Results Baseline demographic characteristics of patients were similar (P >.05). Mean time to portal venous access was 46 minutes ± 37 for conventional TIPS and 31 minutes ± 19 for intravascular US–guided TIPS (P =.007). Intravascular US guidance allowed significantly shorter times (48 min ± 30 vs 28 min ± 16; P =.01) to portal vein access among operators (n = 5) with limited experience but failed to achieve any significant time savings (44 min ± 43 vs 34 min ± 22; P =.89) among experienced operators (n = 5). Needle pass–related capsular perforation occurred in 17/54 (34%) patients with conventional TIPS and 5/55 (9%) patients with intravascular US–guided TIPS (P =.004). Radiation dose was 2,376 mGy ± 1,816 for conventional TIPS and 1,592 mGy ± 1,263 for intravascular US–guided TIPS (P =.004). Conclusions Intravascular US–guided portal vein access during TIPS creation is associated with shorter portal vein access times, decreased needle pass–related capsular perforations, and reduced radiation dose.
AB - Purpose To compare safety and effectiveness of intravascular ultrasound (US)–guided portal vein access during transjugular intrahepatic portosystemic shunt (TIPS) creation with conventional TIPS technique. Materials and Methods In this retrospective study, TIPS creation using intravascular US guidance in 55 patients was compared with conventional TIPS creation in 54 patients by 10 operators over a 3-year period. Operators were classified as experienced if they had performed ≥ 20 TIPS procedures at the beginning of the study period. Time to portal vein access, total radiation dose, and needle pass–related capsular perforation were recorded. Results Baseline demographic characteristics of patients were similar (P >.05). Mean time to portal venous access was 46 minutes ± 37 for conventional TIPS and 31 minutes ± 19 for intravascular US–guided TIPS (P =.007). Intravascular US guidance allowed significantly shorter times (48 min ± 30 vs 28 min ± 16; P =.01) to portal vein access among operators (n = 5) with limited experience but failed to achieve any significant time savings (44 min ± 43 vs 34 min ± 22; P =.89) among experienced operators (n = 5). Needle pass–related capsular perforation occurred in 17/54 (34%) patients with conventional TIPS and 5/55 (9%) patients with intravascular US–guided TIPS (P =.004). Radiation dose was 2,376 mGy ± 1,816 for conventional TIPS and 1,592 mGy ± 1,263 for intravascular US–guided TIPS (P =.004). Conclusions Intravascular US–guided portal vein access during TIPS creation is associated with shorter portal vein access times, decreased needle pass–related capsular perforations, and reduced radiation dose.
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U2 - 10.1016/j.jvir.2016.05.010
DO - 10.1016/j.jvir.2016.05.010
M3 - Article
C2 - 27363298
AN - SCOPUS:84977540467
SN - 1051-0443
VL - 27
SP - 1154
EP - 1159
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 8
ER -