Use of transabdominal ultrasound-guided transjugular portal vein puncture on radiation dose in transjugular intrahepatic portosystemic shunt formation

Tavare, Aniket; Wigham, Andrew; Hadjivassilou, Anastasia; Alvi, Abdulrahman; Papadopoulou, Anthie; Goode, Antony; Woodward, Nick; Patch, David; Yu, Dominic; Davies, Neil

doi:10.5152/dir.2016.15601

Cited by 27 publications

(40 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The key technical element of the procedure is the portal vein puncture. This may be facilitated by ultrasound guidance, which has been shown to reduce screen time 178. Stent placement should not compromise future options for transplantation, and should therefore not extend towards splenic/superior mesenteric vein confluence, as this disrupts surgical portal vein anastomosis.…”

Section: Procedural Detailsmentioning

confidence: 99%

Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension

Tripathi

Stanley

Hayes

et al. 2020

Gut

Self Cite

211

220

View full text Add to dashboard Cite

These guidelines on transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the management of portal hypertension have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the Liver Section of the BSG. The guidelines are new and have been produced in collaboration with the British Society of Interventional Radiology (BSIR) and British Association of the Study of the Liver (BASL). The guidelines development group comprises elected members of the BSG Liver Section, representation from BASL, a nursing representative and two patient representatives. The quality of evidence and grading of recommendations was appraised using the GRADE system. These guidelines are aimed at healthcare professionals considering referring a patient for a TIPSS. They comprise the following subheadings: indications; patient selection; procedural details; complications; and research agenda. They are not designed to address: the management of the underlying liver disease; the role of TIPSS in children; or complex technical and procedural aspects of TIPSS.

show abstract

Section: Procedural Detailsmentioning

confidence: 99%

Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension

Tripathi

Stanley

Hayes

et al. 2020

Gut

Self Cite

211

220

View full text Add to dashboard Cite

show abstract

“…It is possible that the lack of complementary ultrasound guidance contributed to the technical challenges encountered, especially in the setting of PLSVC. Transabdominal ultrasound is another option for portal venous access guidance and also has been shown to reduce procedure times and radiation doses (Cam et al 2020 ; Tavare et al 2017 ), and likely more readily available and cost effective than intravascular ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Transjugular intrahepatic portosystemic shunt creation via isolated persistent left superior vena cava: a case series

et al. 2020

View full text Add to dashboard Cite

Background Isolated persistent left superior vena cava (PLSVC) is a rare vascular anatomic variant, which can be an incidental finding at the time of an endovascular procedure. Case presentation This report describes the technical success, adverse events, and clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) creation via isolated PLSVC. Three adult patients with cirrhosis and isolated PLSVC underwent TIPS placement successfully with one major adverse event. Two patients required TIPS revision within 90 days. There were no deaths within 90 days. Conclusions TIPS creation via isolated PLSVC is feasible using standard techniques with a left jugular vein approach. Caution is warranted during the procedure to assess for any aberrant drainage pattern to the left atrium and to prepare for potentially challenging instrument navigation through the coronary sinus.

show abstract

“…An ultrasound-assisted technique was used to facilitate TIPSS insertion, as described in a previous publication. 24 The rest of the TIPSS insertion technique did not differ from established standards. 25 Once the covered stent was deployed, local thrombolysis was performed using fountain catheters or conventional catheters with infusion of tPA at a dose of 1 mg/h until satisfactory improvement.…”

Section: Local Cdt Protocolmentioning

confidence: 93%

“…Local CDT was performed using a transjugular approach with creation of an intrahepatic portosystemic shunt (TIPSS). An ultrasound‐assisted technique was used to facilitate TIPSS insertion, as described in a previous publication . The rest of the TIPSS insertion technique did not differ from established standards .…”

Section: Methodsmentioning

confidence: 99%

A stepwise thrombolysis regimen in the management of acute portal vein thrombosis in patients with evidence of intestinal ischaemia

Benmassaoud

Alrubaiy

et al. 2019

Aliment Pharmacol Ther

Self Cite

View full text Add to dashboard Cite

Summary Background Anticoagulation alone in acute, extensive portomesenteric vein thrombosis (PVT) does not always result in spontaneous clot lysis, and leaves the patient at risk of complications including intestinal infarction and portal hypertension. Aim To develop a new standard of care for patients with acute PVT and evidence of intestinal ischaemia. Methods We present a case series of patients with acute PVT and evidence of intestinal ischaemia plus ongoing symptoms despite initial systemic anticoagulation, who were treated with a thrombolysis protocol between 2014 and 2019. This stepwise protocol initially uses low‐dose systemic alteplase, and in patients with ongoing abdominal pain, and no evidence of radiological improvement, is followed by local clot dissolution therapy (CDT) through a TIPSS. Outcomes and safety were assessed. Results Twenty‐two patients were included. The mean age was 44.6 (standard deviation [SD] 16.0) years, and 64% had an identifiable prothrombotic risk factor. All patients had intestinal wall oedema and 77% had complete occlusion of all portomesenteric veins. Systemic thrombolysis was started 18.7 (SD 11.2) days after the onset of symptoms. 55% of patients underwent TIPSS insertion for CDT. At the end of treatment, symptoms resolved in 91% of patients and recanalisation in 86%. Only one patient required resection for intestinal ischaemia, and there were no deaths. Major complications occurred in two patients (9%). Conclusions Our stepwise protocol is effective, resulting in good recanalisation rates. It can be commenced early while organising transfer to a centre capable of performing local CDT.

show abstract

Use of transabdominal ultrasound-guided transjugular portal vein puncture on radiation dose in transjugular intrahepatic portosystemic shunt formation

Cited by 27 publications

References 34 publications

Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension

Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension

Transjugular intrahepatic portosystemic shunt creation via isolated persistent left superior vena cava: a case series

A stepwise thrombolysis regimen in the management of acute portal vein thrombosis in patients with evidence of intestinal ischaemia

Contact Info

Product

Resources

About