Utility of Intravascular US–Guided Portal Vein Access during Transjugular Intrahepatic Portosystemic Shunt Creation: Retrospective Comparison with Conventional Technique in 109 Patients

Anil K. Pillai, Brice Andring, Nicholas Faulconer, Stephen P. Reis, Yin Xi, Ikponmwosa Iyamu, Patrick D. Suthpin, Sanjeeva P. Kalva

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1154-1159
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume27
Issue number8
DOIs
StatePublished - Aug 1 2016

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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