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Efficacy of Doppler ultrasonography for assessment of transjugular intrahepatic portosystemic shunt patency

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Abstract

Purpose

To assess the efficacy of Doppler ultrasonography (US) as a noninvasive method for monitoring patency of the transjugular intrahepatic portosystemic shunt (TIPS).

Methods

Twenty-nine patients who had received TIPS for bleeding esophagogastric varices and/or refractory ascites with portal hypertension underwent Doppler US studies within 2 weeks after TIPS. Further studies were performed in 15 of them at 6 months, in 9 at 1 year, and in 4 at 2 years for a total of 57 US studies. The US findings were compared with the angiographic findings obtained at the same time.

Results

In 45 of the 57 studies, shunt patency was found by Doppler US, correlating to 44 patencies and one occlusion on angiography. Doppler signal in the shunt could not be detected in 12 studies resulting in the diagnosis of shunt occlusion. This correlated with angiographic occlusion in 8 studies and patency in the remaining 4. All angiographically patent shunts that were occluded by Doppler US had various degrees of stenosis. A number of technical factors were found to be responsible for Doppler US false-positive or false-negative diagnoses, some related to the type of stent used. The Doppler US sensitivity was therefore 92%, the specificity 89%.

Conclusion

Doppler US is a reliable noninvasive method to evaluate patency of TIPS.

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References

  1. Rösch J, Hanafee WN, Snow H (1969) Transjugular portal venography and ragiologic portacaval shunt: An experimental study. Radiology 92:1112–1114

    PubMed  Google Scholar 

  2. Rösch J, Hanafee WN, Snow H, Barenfus M, Gray R (1971) Transjugular intrahepatic portacaval shunt. Am J Surg 121:588–592

    Article  PubMed  Google Scholar 

  3. Burgener FA, Gutierrez OH (1979) Nonsurgical production of intrahepatic portosystemic venous shunts in portal hypertension with the double lumen balloon catheter. ROFO 130:686–688

    PubMed  CAS  Google Scholar 

  4. Colapinto RF, Stronell TD, Birch SJ, Langer B, Blendis LM, Greig PD, Gilas T (1982) Creation of an intrahepatic portosystemic shunt with a Gruntzig balloon catheter. Can Med Assoc J 126:267–268

    PubMed  CAS  Google Scholar 

  5. Colapinto RF, Stronell RD, Gildiner M, Ritchie AC, Langer B, Taylor BR, Blendis LM (1983) Formation of intrahepatic portosystemic shunts using a balloon dilatation catheter: Preliminary clinical experience. AJR 140:708–714

    Google Scholar 

  6. Palmaz JC, Sibbitt RR, Reuter SR, Garcia F, Tio F (1985) Expandable intrahepatic portacaval shunt stents: Early experience in the dog. AJR 145:821–825

    PubMed  CAS  Google Scholar 

  7. Rösch J, Uchida BT, Putnam JS, Buschman RW, Law RD, Hershey AL (1987) Experimental intrahepatic portacaval anastomosis: Use of expandable Gianturco stents. Radiology 162:481–485

    PubMed  Google Scholar 

  8. Richter GM, Palmaz JC, Noldge G, Roessle M, Siegerstetter V, Franke M, Wenz W (1989) Der transjugulare intrahepatische portosystemische stent-shunt (TIPSS). Radiology 29:406–411

    CAS  Google Scholar 

  9. Zemel G, Katzen BT, Becker GJ, Benenati JF, Sallee DS (1991) Percutaneous transjugular portosystemic shunt. JAMA 266:390–393

    Article  PubMed  CAS  Google Scholar 

  10. Ring EJ, Lake JR, Roberts JP, Gordon RL, LaBerge JM, Read AE, Sterneck MR, Ascher NL (1992) Percutaneous transjugular intrahepatic hepatic vein-portal vein shunts to control variceal bleeding prior to liver transplantation. Ann Intern Med 116:304–309

    PubMed  CAS  Google Scholar 

  11. Moriyasu F, Ban N, Nishida O, Nakamura T, Sakai M, Miyake T, Uchino H (1986) ‘Congestion index’ of the portal vein. AJR 146:735–739

    PubMed  CAS  Google Scholar 

  12. Surratt RS, Middleton WD, Darcy MD, Melson GL, Brink JA (1993) Morphologic and hemodynamic findings at sonography before and after creation of a transjugular intrahepatic portosystemic shunt. AJR 160:627–630

    PubMed  CAS  Google Scholar 

  13. Grant EG, Tessler FN, Gomes AS, Perrella RR, Holmes CL, Duerinckx AJ, Busuttil RW (1990) Color Doppler imaging of portosystemic shunts. AJR 154:393–397

    PubMed  CAS  Google Scholar 

  14. Longo JM, Bilbao JI, Rousseau HP, Joffre FG, Vinel JP (1992) Color Doppler US guidance in transjugular placement of intrahepatic portosystemic shunts. Radiology 184:281–284

    PubMed  CAS  Google Scholar 

  15. Foshager MC, Ferral H, Finlay DE, Castañeda-Zúñiga WR, Letourneau JG (1994) Color Doppler sonography of transjugular intrahepatic portosystemic shunts (TIPS). AJR 163:105–111

    PubMed  CAS  Google Scholar 

  16. Ferral H, Foshager MC, Bjamason H, Finlay DE, Hunter DW, Castañeda-Zúñiga WR, Bjamason H, Finlay DE, Hunter DW, Castañeda-Zúñiga WR, Letourneau JG (1993) Early sonographic evaluation of the transjugular intrahepatic portosystemic shunt (TIPS). Cardiovasc Intervent Radiol 16:275–279

    PubMed  CAS  Google Scholar 

  17. Chong WK, Malisch TA, Mazer MJ, Lind CD, Worrell JA, Richards WD (1993) Transjugular intrahepatic portosystemic shunt: US assessment with maximum flow velocity. Radiology 189:789–793

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Wakayama Medical College, 27 Banchi, 7 Bancho, 640, Wakayama City, Japan

    Masashi Kimura, Morio Sato, Nobuyuki Kawai, Kayo Tanaka, Tetsuo Sonomura, Kazushi Kishi, Yasukazu Shioyama, Masaki Terada & Ryusaku Yamada

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  1. Masashi Kimura
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  2. Morio Sato
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  3. Nobuyuki Kawai
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  4. Kayo Tanaka
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  5. Tetsuo Sonomura
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  6. Kazushi Kishi
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  7. Yasukazu Shioyama
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  8. Masaki Terada
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  9. Ryusaku Yamada
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Kimura, M., Sato, M., Kawai, N. et al. Efficacy of Doppler ultrasonography for assessment of transjugular intrahepatic portosystemic shunt patency. Cardiovasc Intervent Radiol 19, 397–400 (1996). https://doi.org/10.1007/BF02577626

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  • DOI: https://doi.org/10.1007/BF02577626

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