Radiation exposure during transjugular intrahepatic portosystemic shunt creation in patients with complete portal vein thrombosis or portal cavernoma.
Esophageal and Gastric Varices
/ diagnostic imaging
Female
Fluoroscopy
Gastrointestinal Hemorrhage
/ diagnostic imaging
Hemangioma, Cavernous
/ diagnostic imaging
Humans
Liver Neoplasms
/ diagnostic imaging
Male
Middle Aged
Portal Vein
/ diagnostic imaging
Portasystemic Shunt, Transjugular Intrahepatic
Radiation Exposure
Retrospective Studies
Ultrasonography, Interventional
Venous Thrombosis
/ diagnostic imaging
Ascites
Bleeding
Cirrhosis
Liver
Journal
La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
08
10
2019
accepted:
06
02
2020
pubmed:
20
2
2020
medline:
26
6
2020
entrez:
20
2
2020
Statut:
ppublish
Résumé
This study aims to evaluate radiation exposure in patients with complete portal vein thrombosis (CPVT) or portal cavernoma (PC) undergoing transjugular intrahepatic portosystemic shunt (TIPS) creation using real-time ultrasound guidance for portal vein targeting. This is a single institution retrospective analysis. Between August 2009 and September 2018, TIPS was attempted in 49 patients with CPVT or PC. Radiation exposure (dose area product [DAP], air KERMA (AK) and fluoroscopy time [FT]), technical success, clinical success, complications and survival were analyzed. In total, 29 patients had CPVT and 20 patients had PC. 41/49 patients had cirrhosis. TIPS indications were refractory ascites (n = 25), variceal bleeding (n = 16) and other (n = 8). TIPS was successfully placed in 94% (46/49) of patients via a transjugular approach alone (n = 40), a transjugular/transhepatic approach (n = 5) and a transjugular/transsplenic approach (n = 1). Median DAP was 261 Gy * cm In our experience, the use of real-time ultrasound guidance allowed the majority of the TIPS to be performed via a transjugular approach alone with a reasonably low radiation exposure considering the high technical difficulties of the selected cohort of patients with CVPT or PC.
Sections du résumé
BACKGROUND
BACKGROUND
This study aims to evaluate radiation exposure in patients with complete portal vein thrombosis (CPVT) or portal cavernoma (PC) undergoing transjugular intrahepatic portosystemic shunt (TIPS) creation using real-time ultrasound guidance for portal vein targeting.
MATERIALS AND METHODS
METHODS
This is a single institution retrospective analysis. Between August 2009 and September 2018, TIPS was attempted in 49 patients with CPVT or PC. Radiation exposure (dose area product [DAP], air KERMA (AK) and fluoroscopy time [FT]), technical success, clinical success, complications and survival were analyzed.
RESULTS
RESULTS
In total, 29 patients had CPVT and 20 patients had PC. 41/49 patients had cirrhosis. TIPS indications were refractory ascites (n = 25), variceal bleeding (n = 16) and other (n = 8). TIPS was successfully placed in 94% (46/49) of patients via a transjugular approach alone (n = 40), a transjugular/transhepatic approach (n = 5) and a transjugular/transsplenic approach (n = 1). Median DAP was 261 Gy * cm
CONCLUSION
CONCLUSIONS
In our experience, the use of real-time ultrasound guidance allowed the majority of the TIPS to be performed via a transjugular approach alone with a reasonably low radiation exposure considering the high technical difficulties of the selected cohort of patients with CVPT or PC.
Identifiants
pubmed: 32072390
doi: 10.1007/s11547-020-01155-5
pii: 10.1007/s11547-020-01155-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM