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CardioVascular and Interventional Radiology

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14-08-2023 | Portal Vein Thrombosis | Clinical Investigation

Safety and Feasibility of Gun-Sight Technique for Transjugular Intra-hepatic Portosystemic Shunt (TIPS) Creation

Authors: Nathan Elie Frenk, Taedo Jake Choi, Lauren Sunhye Park, Emil Israel Cohen, George Emmet Lynskey, Saher Salim Sabri

Published in: CardioVascular and Interventional Radiology | Issue 9/2023

Abstract

Purpose

To review technical details, indications for use, success rates and complications of gun-sight technique for transjugular intra-hepatic portosystemic shunt (TIPS) creation.

Materials and Methods

A multicenter retrospective review was performed. Forty-two TIPS procedures with gun-sight technique were identified between 2016 and 2021. Eighty-six percent of patients had portal vein thrombosis (PVT), and 21% had undergone prior failed TIPS creation. Demographics, procedure details and outcomes were reviewed. Differences between the groups, event rates and patency rates were evaluated using nonparametric two-sample Wilcoxon rank-sum (Mann–Whitney) test, Fisher’s exact test, Kaplan–Meier curves, and log-rank test.

Results

Technical success was 98%. Sixty-seven percent of subjects had transsplenic and 26% had transhepatic access for TIPS creation. Twenty-one adverse events were noted (48%), four of which were definitely related and four were probably related to the use of gun-sight technique. Early (within 90 days) thrombosis occurred in 7/41 patients (17%), all of whom had existing PVT.

Conclusion

Gun-sight technique for TIPS creation has a high success rate in this challenging cohort of patients. While complications can occur, most of the adverse events noted were likely associated with TIPS creation itself rather than gun-sight. Early thrombosis only occurred in patients with PVT.

Level of Evidence Level 4, Case Series.

Graphic Abstract

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Title: Safety and Feasibility of Gun-Sight Technique for Transjugular Intra-hepatic Portosystemic Shunt (TIPS) Creation
Authors: Nathan Elie Frenk
Taedo Jake Choi
Lauren Sunhye Park
Emil Israel Cohen
George Emmet Lynskey
Saher Salim Sabri
Publication date: 14-08-2023
Publisher: Springer US
Keywords: Portal Vein Thrombosis
Portal Vein Thrombosis
Thrombosis
Published in: CardioVascular and Interventional Radiology / Issue 9/2023
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-023-03528-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Safety and Feasibility of Gun-Sight Technique for Transjugular Intra-hepatic Portosystemic Shunt (TIPS) Creation

Abstract

Purpose

Materials and Methods

Results

Conclusion

Graphic Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

Graphic Abstract

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