Use of Virtual Target Fluoroscopic Display of Three-Dimensional CO2 Wedged Hepatic Vein Portography for TIPS Placement

Leger, Thomas; Petit, Arthur; Moustarhfir, Yassine; Ajavon, Y.; Sellier, N.; Séror, Olivier

doi:10.1007/s00270-021-02922-1

Cited by 5 publications

(4 citation statements)

References 18 publications

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Section: Discussionmentioning

confidence: 99%

“…However, in these cases, retrograde portographies were predominantly performed after injecting 40 mL of CO2, compared to classic retrograde portographies after injecting 10 mL of contrast medium containing iodine. [3][4][5][6][7]12 So far, we are not aware of any study that examined retrograde portography protocols for contrast media containing iodine with regard to different catheter diameters and injection volumes.…”

Section: Discussionmentioning

confidence: 99%

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High volume retrograde portography for better discrimination of the portal vein during TIPS procedure

Altenbernd

Zimmer

Andrae

et al. 2022

Acta Radiologica Open

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Background: Imaging of the portal vein prior to puncture for TIPS is essential. Purpose: With this study, we examined a modified retrograde portography with regard to the reliable representation of the portal vein. Material and Methods: Prospective evaluation of 65 TIPS interventions with regard to the delimitation of the portal vein and the exact parameters of retrograde portography such as catheter diameter and contrast medium volume per injection. Results: Retrograde portographies with a large-lumen catheter (10 F) and a large contrast medium volume (40 mL) were performed in 35/63 patients with significantly better delineation of the portal vein than when using 5 F catheters with 10 mL contrast medium. Conclusion: The so-called high volume retrograde portography leads to better delimitation of the portal vein during TIPS application.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

High volume retrograde portography for better discrimination of the portal vein during TIPS procedure

Altenbernd

Zimmer

Andrae

et al. 2022

Acta Radiologica Open

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“…In such patients, both conventional and intravascular ultrasound (IVUS)-guided TIPS creation can be considered. Cone beam computed tomography, 10 intracardiac echocardiography (ICE), 11 a three-dimensional (3D) virtual target fluoroscopic display 12 can improve the visualization and access portal vein branches during TIPS creation in these patients with complex anatomy. In some cases, opacification of the portal vein via a percutaneous transhepatic, trans-splenic, or para-umbilical vein is used as an additional tool to improve the success rate in accessing the portal vein.…”

Section: Endovascular Treatments For Budd-chiarimentioning

confidence: 99%

Advanced Imaging Techniques Used in Direct Portosystemic Shunt Creation in Budd-Chiari Syndrome with Complex Venous Anatomy

Rostami,

Fickert,

Morris

et al. 2024

Semin intervent Radiol

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“…Several approaches have been tested to improve the targeting of the PV, including carbon dioxide (CO 2 ) or iodinated contrast agent wedged hepatic portography [ 11 ], guidance with transabdominal ultrasound (US) [ 12 ], intravascular ultrasound (IVUS) [ 13 ], and magnetic resonance angiography [ 14 ]. More recently, several three-dimensional (3D) image-fusion guidance methods have been suggested, using cone-beam computed tomography (CBCT) during TIPS placement to reduce the procedure time and complication risks [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Double C-Arm Digital Subtraction Angiography Guidance During Transjugular Intrahepatic Portosystemic Shunt Placement

Bai

Tan

et al. 2023

Med Sci Monit

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This study aimed to evaluate the safety and efficacy of portal vein puncture with a new guidance system using double C-arm digital subtraction angiography (DSA) during transjugular intrahepatic portosystemic shunt (TIPS) placement. Material/Methods:The procedure details of TIPS placements performed on 39 patients in our center between January and December 2021 were retrospectively analyzed. The procedure was performed under double C-arm DSA guidance (study group) and C-arm DSA (control group) in 18 and 21 patients, respectively. We analyzed the procedure's technical success, duration of the overall procedure, portal vein puncture, fluoroscopy, radiation exposure, complications, and mortality and morbidity rates 30 days after the procedure. Results:TIPS placement was performed successfully in all patients. The mean portal vein puncture time in the study group (9±5.7 min) was significantly shorter than in the control group (33±14.9 min, p=0.02). The complete mean dose area product of the procedure showed no significant differences (study group, 126±53 Gy/cm 2 ; control group. 142±66 Gy/cm 2 ; p=0.42). The intraprocedural complication rates were 0% and 19% in the study and control groups, respectively (p=0.04). The 30-day post-procedural mortality rate in the control group was 4.8% (1/21), with no deaths from technical complications. Conclusions:Double C-arm DSA guidance is a safe and effective method to assist TIPS placement. This approach may result in shorter portal vein puncture time and lower intraprocedural complication rates.

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Use of Virtual Target Fluoroscopic Display of Three-Dimensional CO2 Wedged Hepatic Vein Portography for TIPS Placement

Cited by 5 publications

References 18 publications

High volume retrograde portography for better discrimination of the portal vein during TIPS procedure

High volume retrograde portography for better discrimination of the portal vein during TIPS procedure

Advanced Imaging Techniques Used in Direct Portosystemic Shunt Creation in Budd-Chiari Syndrome with Complex Venous Anatomy

Double C-Arm Digital Subtraction Angiography Guidance During Transjugular Intrahepatic Portosystemic Shunt Placement

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