Balloon occlusion versus wedged hepatic venography using iodinated contrast for targeting the portal vein during TIPS
| Autor: | Jean-Michel Bartoli, Antonin Flavian, J.-M. Caporossi, C. Muller, Jean-Yves Gaubert, A Reyre, Guy Moulin, Vincent Vidal, Arthur Varoquaux, Alexis Jacquier |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Portal vein Venography Contrast Media Balloon Iodinated contrast Triiodobenzoic Acids Medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Portal hypertension Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Portal Vein Hepatic venography General Medicine Phlebography Balloon Occlusion Middle Aged medicine.disease Balloon occlusion TIPS Female Radiology Portasystemic Shunt Transjugular Intrahepatic business Intrahepatic hematoma |
| Zdroj: | Diagnostic and interventional imaging. 96(4) |
| ISSN: | 2211-5684 |
| Popis: | Purpose To assess the efficacy, safety and gain in procedure time of the technique of balloon occlusion hepatic venography with iodinated contrast used to target the portal vein during TIPS. The technique is assessed versus wedged hepatic venography. Materials and methods Fifty-eight TIPS were prospectively included. The portal vein was located in 30 cases by the wedged hepatic venography (group 1) and in 28 cases by balloon occlusion hepatic venography (group 2). To compare both techniques a “portogram quality” score was defined using a 5 points scale. The time required to achieve portal puncture was also recorded. The complications of both procedures were assessed and classified in groups as intrahepatic hematoma or intraperitoneal hemorrhage. Results The right portal vein was visualized in a significantly higher number of patients using balloon than with wedged retrograde venography 71.3% (20/28) versus 13.3% (4/30) respectively ( P = 0.002). The quality score for the portogram was significantly higher for balloon hepatic venography 2.21 than for wedged hepatic venography 1.07 ( P = 0.002). The mean time required to puncture the portal vein was significantly shorter when the right branch of the portal vein was visualized 21 min versus 33.5 min ( P = 0.046). We recorded one intrahepatic hematoma (3.3%) and 4 intraperitoneal hemorrhage (13.3%) secondary to wedged hepatic venography. There were no complications with balloon occlusion hepatic venography ( P = 0.053). Conclusion The use of balloon occlusion hepatic venography improves the quality of the retrograde portal venography to target the portal vein and decreases procedure time. The balloon technique is also burdened with fewer complications than the standard wedged hepatic venography. |
| Databáze: | OpenAIRE |
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