Ultrasonographic guidance for portal vein access during transjugular intrahepatic portosystemic shunt (TIPS) placement - 28/06/19
Abstract |
Purpose |
The purpose of our study was to retrospectively assess the safety and efficacy of percutaneous real-time ultrasound guidance for portal vein puncture during transjugular intrahepatic portosystemic shunt (TIPS) placement.
Materials and methods |
Between January 2011 and November 2018, procedure details and outcome were retrospectively analyzed for 224 patients who underwent TIPS placement using real-time ultrasound guidance for portal vein puncture. There were 175 men and 49 women with a mean age of 52.7±10.6 (SD) years (range: 22–82 years). For each procedure, technical success, primary ultrasound guidance success, portosystemic pressure gradient, duration of the intervention, procedural complications, radiation exposure, mortality and morbidity rates at day 30 post-procedure were recorded for data analysis.
Results |
Technical success rate was 100.0% with a success rate of the primary ultrasound guidance of 97.8% (219/224; 95% CI: 95.8–99.7). Mean duration of the procedure was 86.2±41.7 (SD) min (range: 22.0–267.0min). Mean dose-area product was 62.0±50.2 (SD) Gy.cm2 (range: 3.7–306.5Gy.cm2). Twelve complications (12/224; 5.4%) occurred in ten patients during TIPS procedures including 8 arterial punctures (3.6%) and 4 biliary punctures (1.8%). Four complications (4/224; 1.8%) were clinically significant. Mortality rate at day 30 after the procedure was 9.8% (22/224), without any patient dying from technical complications.
Conclusion |
Real-time ultrasound guidance is a safe technique to assist in the creation of TIPS and may allow for lower radiation exposure.
El texto completo de este artículo está disponible en PDF.Keywords : Transjugular intrahepatic portosystemic shunt (TIPS), Imaging guidance, Ultrasound, Portal vein puncture, Portal hypertension
Esquema
Vol 100 - N° 7-8
P. 445-453 - juillet 2019 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.