nach oben

European Radiology

Erschienen in:

19.02.2018 | Vascular-Interventional

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

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

Erschienen in: European Radiology | Ausgabe 8/2018

Einloggen, um Zugang zu erhalten

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.

Rossle M (2013) TIPS: 25years later. J Hepatol 59:1081–1093CrossRefPubMed

Bettinger D, Schultheiss M, Boettler T, Muljono M, Thimme R, Rossle M (2016) Procedural and shunt-related complications and mortality of the transjugular intrahepatic portosystemic shunt (TIPSS). Aliment Pharmacol Ther 44:1051–1061CrossRefPubMed

Adamus R, Pfister M, Loose RW (2009) Enhancing transjugular intrahepatic portosystemic shunt puncture by using three-dimensional path planning based on the back projection of two two-dimensional portographs. Radiology 251:543–547CrossRefPubMed

Farsad K, Fuss C, Kolbeck KJ et al (2012) Transjugular intrahepatic portosystemic shunt creation using intravascular ultrasound guidance. J Vasc Interv Radiol 23:1594–1602CrossRefPubMed

Kee ST, Ganguly A, Daniel BL et al (2005) MR-guided transjugular intrahepatic portosystemic shunt creation with use of a hybrid radiography/MR system. J Vasc Interv Radiol 16:227–234CrossRefPubMed

Ketelsen D, Groezinger G, Maurer M et al (2016) Three-dimensional C-arm CT-guided transjugular intrahepatic portosystemic shunt placement: feasibility, technical success and procedural time. Eur Radiol 26:4277–4283CrossRefPubMed

Tsauo J, Luo X, Ye L, Li X (2015) Three-dimensional path planning software-assisted transjugular intrahepatic portosystemic shunt: a technical modification. Cardiovasc Intervent Radiol 38:742–746CrossRefPubMed

Maleux G, Nevens F, Heye S, Verslype C, Marchal G (2006) The use of carbon dioxide wedged hepatic venography to identify the portal vein: comparison with direct catheter portography with iodinated contrast medium and analysis of predictive factors influencing level of opacification. J Vasc Interv Radiol 17:1771–1779CrossRefPubMed

Petersen B, Uchida BT, Timmermans H, Keller FS, Rosch J (2001) Intravascular US-guided direct intrahepatic portacaval shunt with a PTFE-covered stent-graft: feasibility study in swine and initial clinical results. J Vasc Interv Radiol 12:475–486CrossRefPubMed

10.

Rose SC, Pretorius DH, Nelson TR et al (2000) Adjunctive 3D US for achieving portal vein access during transjugular intrahepatic portosystemic shunt procedures. J Vasc Interv Radiol 11:611–621CrossRefPubMed

11.

Krajina A, Hulek P, Fejfar T, Valek V (2012) Quality improvement guidelines for Transjugular Intrahepatic Portosystemic Shunt (TIPS). Cardiovasc Intervent Radiol 35:1295–1300CrossRefPubMedPubMedCentral

12.

Soderman M, Babic D, Homan R, Andersson T (2005) 3D roadmap in neuroangiography: technique and clinical interest. Neuroradiology 47:735–740CrossRefPubMed

13.

Dariushnia SR, Haskal ZJ, Midia M et al (2016) Quality improvement guidelines for transjugular intrahepatic portosystemic shunts. J Vasc Interv Radiol 27:1–7CrossRefPubMed

14.

Patel BN, Kapoor BS, Borghei P, Shah NA, Lockhart ME (2011) Carbon dioxide as an intravascular imaging agent: review. Curr Probl Diagn Radiol 40:208–217CrossRefPubMed

15.

Itoh S, Ikeda M, Achiwa M, Satake H, Iwano S, Ishigaki T (2004) Late-arterial and portal-venous phase imaging of the liver with a multislice CT scanner in patients without circulatory disturbances: automatic bolus tracking or empirical scan delay? Eur Radiol 14:1665–1673CrossRefPubMed

16.

Petersen B (2003) Intravascular ultrasound-guided direct intrahepatic portacaval shunt: description of technique and technical refinements. J Vasc Interv Radiol 14:21–32PubMed

17.

Luo X,Wang X, Zhao Y et al (2017) Real-time 3D CT image guidance for transjugular intrahepatic portosystemic shunt creation using preoperative CT: A prospective feasibility study of 20 patients. Am J Roentgenol 208(1):W11–W16

18.

Miraglia R, Maruzzelli L, Cortis K et al (2016) Radiation exposure in transjugular intrahepatic portosystemic shunt creation. Cardiovasc Interv Radiol 39(2):210–217

19.

Tavare A N, Wigham A, Hadjivassilou A et al (2017) Use of transabdominal ultrasound-guided transjugular portal vein puncture on radiation dose in transjugular intrahepatic portosystemic shunt formation. Diagn Interv Radiol 23(3):206–210

Titel: Transjugular intrahepatic portosystemic shunt creation: three-dimensional roadmap versus CO2 wedged hepatic venography
verfasst von: Xuefeng Luo
Xiaoze Wang
Jiaze Yu
Yongjun Zhu
Xiaotan Xi
Huaiyuan Ma
Li Yang
Publikationsdatum: 19.02.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5316-3

Neu im Fachgebiet Radiologie

18.04.2024 | Pädiatrische Notfallmedizin | Nachrichten

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

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

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Neu im Fachgebiet Radiologie

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Studie bestätigt Potenzial von KI in der Radiologie

Quantitative Angiografie könnte IVUS-Alternative darstellen

Update Radiologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2018

Progressive supranuclear palsy and idiopathic Parkinson’s disease are associated with local reduction of in vivo brain viscoelasticity

Prediction of rupture risk in anterior communicating artery aneurysms with a feed-forward artificial neural network

From radiation osteitis to osteoradionecrosis: incidence and MR morphology of radiation-induced sacral pathologies following pelvic radiotherapy

Glioma imaging in Europe: A survey of 220 centres and recommendations for best clinical practice

Diffusion tensor magnetic resonance imaging of breast cancer: associations between diffusion metrics and histological prognostic factors

Forensic age assessment by 3.0T MRI of the knee: proposal of a new MRI classification of ossification stages

Neu im Fachgebiet Radiologie

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Studie bestätigt Potenzial von KI in der Radiologie

Quantitative Angiografie könnte IVUS-Alternative darstellen

Update Radiologie