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European Radiology

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01-08-2018 | Vascular-Interventional

Transjugular intrahepatic portosystemic shunt creation: three-dimensional roadmap versus CO₂ wedged hepatic venography

Authors: Xuefeng Luo, Xiaoze Wang, Jiaze Yu, Yongjun Zhu, Xiaotan Xi, Huaiyuan Ma, Li Yang

Published in: European Radiology | Issue 8/2018

Abstract

Objectives

The blind portal vein puncture remains the most challenging step during transjugular intrahepatic portosystemic shunt (TIPS) creation. We performed a prospective randomised clinical trial to compare three-dimensional (3D) roadmap with CO₂ wedged hepatic vein portography for portal vein puncture guidance.

Methods

Between March 2017 and May 2017, 30 patients were enrolled and randomly allocated to the study group (3D roadmap) or the control group (CO₂ wedged hepatic vein portography).

Results

Technical success of TIPS procedures was achieved in all 30 patients. The mean number of needle passes was significantly lower in the study group (2.0 ± 1.0) compared to the control group (3.7 ± 2.5; p = 0.021). A total of six (40%) patients in the study group and three (20%) in the control group required only one puncture for the establishment of TIPS. There were no significant differences in total fluoroscopy time (p = 0.905), total procedure time (p = 0.199) and dose-area product (p = 0.870) between the two groups.

Conclusions

3D roadmap is a safe and technically feasible means for portal vein puncture guidance during TIPS creation, equivalent in efficacy to CO₂ wedged hepatic vein portography. This technique could reduce the number of needle passes, thereby simplifying the TIPS procedure.

Key Points

• 3D roadmap can be used to guide portal vein puncture.

• Compared with CO ₂ venography, 3D roadmap reduced the number of needle passes.

• 3D roadmap has a potential to simplify the TIPS procedure.

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Title: Transjugular intrahepatic portosystemic shunt creation: three-dimensional roadmap versus CO2 wedged hepatic venography
Authors: Xuefeng Luo
Xiaoze Wang
Jiaze Yu
Yongjun Zhu
Xiaotan Xi
Huaiyuan Ma
Li Yang
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 8/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5316-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transjugular intrahepatic portosystemic shunt creation: three-dimensional roadmap versus CO₂ wedged hepatic venography

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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