Value of Doppler Sonography in Revealing Transjugular Intrahepatic Portosystemic Shunt Malfunction

Žižka, Ján; Eliás, P; Krajina, Antonı́n; Michl, A; Lojík, Miroslav; Ryška, Pavel; Mašková, Jana; Hůlek, P; Šafka, Václav; Vaňásek, Tomáš; Bukac̆, Josef

doi:10.2214/ajr.175.1.1750141

Cited by 82 publications

(41 citation statements)

References 28 publications

(74 reference statements)

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“…The sensitivities were only 51%, 34% and 51% respectively. Nevertheless, when using a combination of these three velocity parameters, they achieved 94% sensitivity for detecting shunt stenosis (25). The same result is obtained by Kanterman et al, who investigated the sensitivity of the overall interpretation of the sonographic examination by the radiologist.…”

Section: Hepatic Artery Velocitysupporting

confidence: 62%

“…Based on the first assumption, investigators have attempted to establish a lower limit of normal shunt velocity (Table I) (12,18). On the contrary, several other studies failed to reproduce these good results (20,(22)(23)(24)(25). In order to increase the sensitivity of this parameter, Kanterman et al even propose a lower velocity limit of 90 cm/s (20).…”

Section: Stent Velocitymentioning

confidence: 99%

“…Using a 33% cut-off, their sensitivity decrease to 67%, with specificity unchanged (75%) (20). Zizka et al used the 33% cut-off value yielding a sensitivity of 51% and a PPV of 100% (25).…”

Section: Main Portal Vein Velocitymentioning

confidence: 99%

“…Kanterman et al determined a value of 190 cm/s (20). Zizka et al report a maximum peak velocity of 250 cm/s with a sensitivity of 51% (25).…”

Section: Hepatic Artery Velocitymentioning

confidence: 99%

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Sonographic evaluation of transjugular intrahepatic porto-systemic shunt

Thijs

Bielen

et al. 2013

Journal of the Belgian Society of Radiology

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The purpose of this article is to review the role of sonography before, during and after transjugular intrahepatic portosystemic shunt placement. A sonographic assessment of the liver and abdomen is recommended before the procedure. We illustrate several important sonographic findings for the echographist, which may alter the procedure approach or even preclude transjugular intrahepatic portosystemic shunt placement. The most challenging step during the procedure is the puncture of the right portal vein. Sonography can be a helpful tool in reducing the number of needle passes, thereby reducing the risk of hemorrhagic complications. Because of its non-invasive and costbenefit nature, sonography is useful for transjugular intrahepatic portosystemic shunt follow-up. A baseline study at 24 to 48 hours is recommended to discover procedure-related complications. Long-term follow-up is important to detect malfunction of the shunt. Doppler ultrasound is very accurate in detecting shunt thrombosis. however, no consensus exists on the optimal sonographic screening protocol for detecting stenosis. We describe three sonographic parameters to detect transjugular intrahepatic portosystemic shunt stenosis with high sensitivity. finally, additional sonographic parameters and potential pitfalls are provided in order to improve sensitivity.

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Section: Hepatic Artery Velocitysupporting

confidence: 62%

Section: Stent Velocitymentioning

confidence: 99%

“…Using a 33% cut-off, their sensitivity decrease to 67%, with specificity unchanged (75%) (20). Zizka et al used the 33% cut-off value yielding a sensitivity of 51% and a PPV of 100% (25).…”

Section: Main Portal Vein Velocitymentioning

confidence: 99%

“…Kanterman et al determined a value of 190 cm/s (20). Zizka et al report a maximum peak velocity of 250 cm/s with a sensitivity of 51% (25).…”

Section: Hepatic Artery Velocitymentioning

confidence: 99%

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Sonographic evaluation of transjugular intrahepatic porto-systemic shunt

Thijs

Bielen

et al. 2013

Journal of the Belgian Society of Radiology

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“…Stent dysfunction on Doppler ultrasound was defined if the calculated peak velocity in the stent was < 90 or > 190 cm/s, and/or the change in peak velocity decreased by > 40 cm/s or increased by > 60 cm/s from baseline measurements. A decrease in portal vein velocity of > 30 cm/s from the baseline value was also considered as evidence of stent dysfunction (35)(36)(37). Stent dysfunction on CT was suspected if the stent showed filling defects or luminal narrowing.…”

Section: Study Endpoints and Definitionsmentioning

confidence: 99%

Stent Dysfunction After Transjugular Intrahepatic Portosystemic Shunt: A 14-Year Experience from a Single Tertiary Medical Center

Kim

Gwon

et al. 2017

Iran J Radiol

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Background: The predisposing factors leading to transjugular intrahepatic portosystemic shunt (TIPS) dysfunction, other than the use of bare stents, which are often the only available options, have not been elucidated well to date. Objectives: To analyze clinical outcomes after TIPS created with bare stents and to assess risk factors for stent dysfunction. Patients and Methods: A total of 102 patients undergoing TIPS between January 1999 and December 2012 were retrospectively assessed. The incidence of stent dysfunction was evaluated, and associated risk factors were analyzed. Results: Symptom recurrence was observed in 51 (50%) patients, and TIPS revision was required in 37 (36%) during the mean followup period of 1889 days. The median stent patency and survival times were 470 and 1783 days, respectively. The only independent risk factor for stent dysfunction was portal trunk (right, left, or main portal trunk) access (P = 0.006). The median stent patency with segmental branch access (538 days) was significantly longer than that with portal trunk access (245 days) (P = 0.007). There were no significant differences in patient survival (P = 0.648), worsening of encephalopathy (P = .0742), or major complications (P = 1.000). Conclusion: TIPS created with segmental portal venous access has superior patency over that of TIPS with portal trunk access. However, we found no significant difference in patient survival, worsening of encephalopathy, or major complications between segmental access and portal trunk access.

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Comparison study of Doppler ultrasound surveillance of expanded polytetrafluoroethylene‐covered stent versus bare stent in transjugular intrahepatic portosystemic shunt

Huang

Fan

et al. 2010

J of Clinical Ultrasound

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Value of Doppler Sonography in Revealing Transjugular Intrahepatic Portosystemic Shunt Malfunction

Abstract: Doppler sonography is an effective primary imaging method for long-term follow-up of patients with TIPS.

Cited by 82 publications

References 28 publications

Sonographic evaluation of transjugular intrahepatic porto-systemic shunt

Sonographic evaluation of transjugular intrahepatic porto-systemic shunt

Stent Dysfunction After Transjugular Intrahepatic Portosystemic Shunt: A 14-Year Experience from a Single Tertiary Medical Center

Comparison study of Doppler ultrasound surveillance of expanded polytetrafluoroethylene‐covered stent versus bare stent in transjugular intrahepatic portosystemic shunt

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