Ultrasonographic guidance for portal vein access during transjugular intrahepatic portosystemic shunt (TIPS) placement
| Autor: | C. Perret, Isabelle Archambeaud, F. Douane, D. Trewick, F. Léauté, Eric Frampas, A. David, R. Liberge, O. Morla, J. Gournay, J. Meyer |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous medicine.medical_treatment Technical success Portal vein Punctures 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Ultrasonography Interventional Aged Retrospective Studies Aged 80 and over Radiological and Ultrasound Technology business.industry Portal Vein Mortality rate Ultrasound Mean age General Medicine Middle Aged medicine.disease Surgery 030220 oncology & carcinogenesis Portal hypertension Female Portasystemic Shunt Transjugular Intrahepatic business Transjugular intrahepatic portosystemic shunt |
| Zdroj: | Diagnostic and interventional imaging. 100(7-8) |
| ISSN: | 2211-5684 |
| Popis: | Purpose The purpose of our study was to retrospectively assess the safety and efficacy of percutaneous real-time ultrasound guidance for portal vein puncture during transjugular intrahepatic portosystemic shunt (TIPS) placement. Materials and methods Between January 2011 and November 2018, procedure details and outcome were retrospectively analyzed for 224 patients who underwent TIPS placement using real-time ultrasound guidance for portal vein puncture. There were 175 men and 49 women with a mean age of 52.7 ± 10.6 (SD) years (range: 22–82 years). For each procedure, technical success, primary ultrasound guidance success, portosystemic pressure gradient, duration of the intervention, procedural complications, radiation exposure, mortality and morbidity rates at day 30 post-procedure were recorded for data analysis. Results Technical success rate was 100.0% with a success rate of the primary ultrasound guidance of 97.8% (219/224; 95% CI: 95.8–99.7). Mean duration of the procedure was 86.2 ± 41.7 (SD) min (range: 22.0–267.0 min). Mean dose-area product was 62.0 ± 50.2 (SD) Gy.cm2 (range: 3.7–306.5 Gy.cm2). Twelve complications (12/224; 5.4%) occurred in ten patients during TIPS procedures including 8 arterial punctures (3.6%) and 4 biliary punctures (1.8%). Four complications (4/224; 1.8%) were clinically significant. Mortality rate at day 30 after the procedure was 9.8% (22/224), without any patient dying from technical complications. Conclusion Real-time ultrasound guidance is a safe technique to assist in the creation of TIPS and may allow for lower radiation exposure. |
| Databáze: | OpenAIRE |
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