A review of recent experience with transjugular intrahepatic portosystemic shunt creation using intravascular ultrasound

Kao, Steven D.; Lee, Edward W.

doi:10.18528/gii180008

Int J Gastrointest Interv

2018

DOI: 10.18528/gii180008

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A review of recent experience with transjugular intrahepatic portosystemic shunt creation using intravascular ultrasound

Steven D. Kao

Edward W. Lee

Abstract: Portal vein access has historically been the most technically challenging step in the creation of transjugular intrahepatic portosystemic shunts (TIPSs). The use of intravascular ultrasound (IVUS) for guidance of portal vein access during TIPS creation has garnered much interest in recent years. Recent literature has suggested potential improvements in procedural metrics that may result from use of IVUS for TIPS. This review aims to provide historical context, detail technical advances and describe recent clin… Show more

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2024

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Predictors of Duration of Transjugular Intrahepatic Portosystemic Shunt (TIPS) Procedure: A Retrospective Single-Center Study

Barrera Gutierrez,

Zullo,

Sclair

et al. 2024

Cureus

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Purpose: To determine the relationship between clinical, procedural, hospital, and physician characteristics with the duration of the transjugular intrahepatic portosystemic shunt (TIPS) procedure. Methods: This retrospective study included patients over 18 years of age who underwent an initial TIPS procedure between January 2005 and August 2020. Exclusion criteria were TIPS performed outside the institution and failed TIPS placement. A total of 154 records were included. Regression analyses were used to identify predictors of procedural duration. Results: The mean age at TIPS placement was 57 years. Seventy percent of patients were male and non-Hispanic whites (80.5%). The mean duration of the TIPS procedure was 169 minutes (SD: 78). Procedural duration was shorter when the etiology of cirrhosis was viral (mean: 144 min, SD: 84, p=0.008); the reason for TIPS was ascites (152, SD: 66, p=0.01); and the procedure did not require additional access (153 min, SD: 67, p=<.0001). The main clinical predictor of procedural duration was baseline bilirubin (Beta coefficient (β): 5.6 min, p=0.0007). In multivariable linear models, in those patients that did not require additional access, bilirubin (β: 4.9 min, p=0.005), etiology of cirrhosis, and physician experience were the main predictors of TIPS procedure duration. The effect of baseline bilirubin on procedural duration increased in the ascites group (β: 19.5 minutes, p=0.006), especially when additional access was not required. Conclusions: The study demonstrates an association between baseline bilirubin, etiology of cirrhosis, and physician experience with the duration of the TIPS procedure. The mechanism underlying the positive association between baseline bilirubin and procedural time is possibly related to the degree of liver fibrosis.

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Predictors of Duration of Transjugular Intrahepatic Portosystemic Shunt (TIPS) Procedure: A Retrospective Single-Center Study

Barrera Gutierrez,

Zullo,

Sclair

et al. 2024

Cureus

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A review of recent experience with transjugular intrahepatic portosystemic shunt creation using intravascular ultrasound

Cited by 1 publication

References 20 publications

Predictors of Duration of Transjugular Intrahepatic Portosystemic Shunt (TIPS) Procedure: A Retrospective Single-Center Study

Predictors of Duration of Transjugular Intrahepatic Portosystemic Shunt (TIPS) Procedure: A Retrospective Single-Center Study

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