Technical and Medium-Term Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt with Fluoroscopy and Additional Trans-abdominal Ultrasound Guidance

Background and Objective The aim of the study is to evaluate the technical and clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) performed with additional transabdominal ultrasound guidance. Material and Methods Patients who underwent TIPS between January 2004 to J...

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Autores principales:	Shyamkumar N. Keshava, Vinu Moses, Anand Sharma, Munawwar Ahmed, Sathya Narayanan, Aswin Padmanabhan, Ashish Goel, Uday Zachariah, C.E. Eapen
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	transjugular intrahepatic portosystemic shunt fluoroscopic ultrasound Medical physics. Medical radiology. Nuclear medicine R895-920
Acceso en línea:	https://doaj.org/article/63abb10ce3a843529c17a2c4ac838a7a
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spelling	oai:doaj.org-article:63abb10ce3a843529c17a2c4ac838a7a2021-11-30T23:59:51ZTechnical and Medium-Term Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt with Fluoroscopy and Additional Trans-abdominal Ultrasound Guidance0971-30261998-380810.1055/s-0041-1735928https://doaj.org/article/63abb10ce3a843529c17a2c4ac838a7a2021-11-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1735928https://doaj.org/toc/0971-3026https://doaj.org/toc/1998-3808Background and Objective The aim of the study is to evaluate the technical and clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) performed with additional transabdominal ultrasound guidance. Material and Methods Patients who underwent TIPS between January 2004 to January 2020 in our center were studied. Technical, hemodynamic, angiographic, and clinical outcome were recorded up to 1 year of follow-up. Results TIPS was attempted in 162 patients (median [range] age 37[3–69] years; 105 were males and 57 were females; Etiology: Budd-Chiari syndrome [BCS] 91, cirrhosis 65, symptomatic acute portal venous thrombosis [PVT] 3, veno-occlusive disease [VOD] 2, congenital portosystemic shunt [CPSS] 1) during the study period. Indication for TIPS was refractory ascites in 135 patients (BCS 86, cirrhosis 49) and variceal bleed in 21 patients (BCS 5, cirrhosis 16). Technical success was seen in 161 of the 162 (99.4%) patients. The tract was created from hepatic vein in 55 patients and inferior vena cava (IVC) in 106 patients. Complications within 1 week post TIPS were seen in 29 of the 162 (18%) patients, of whom one developed unexplained arrhythmia and hypotension and died. Of the patients with available follow-up, clinical success was noted in 120 (81%), while 14 (9%) patients had partial nonresponse and six (4%) had complete nonresponse. Eight (5%) patients died during the follow-up period. Conclusion The technical success of TIPS creation with additional transabdominal ultrasound guidance is very high with low peri-procedural complication rate. It has enabled the inclusion of a wider spectrum of cases like acute PVT and obliterated hepatic veins which were otherwise considered contraindications.Shyamkumar N. KeshavaVinu MosesAnand SharmaMunawwar AhmedSathya NarayananAswin PadmanabhanAshish GoelUday ZachariahC.E. EapenThieme Medical and Scientific Publishers Pvt. Ltd.articletransjugular intrahepatic portosystemic shuntfluoroscopicultrasoundMedical physics. Medical radiology. Nuclear medicineR895-920ENIndian Journal of Radiology and Imaging (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	transjugular intrahepatic portosystemic shunt fluoroscopic ultrasound Medical physics. Medical radiology. Nuclear medicine R895-920
spellingShingle	transjugular intrahepatic portosystemic shunt fluoroscopic ultrasound Medical physics. Medical radiology. Nuclear medicine R895-920 Shyamkumar N. Keshava Vinu Moses Anand Sharma Munawwar Ahmed Sathya Narayanan Aswin Padmanabhan Ashish Goel Uday Zachariah C.E. Eapen Technical and Medium-Term Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt with Fluoroscopy and Additional Trans-abdominal Ultrasound Guidance
description	Background and Objective The aim of the study is to evaluate the technical and clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) performed with additional transabdominal ultrasound guidance. Material and Methods Patients who underwent TIPS between January 2004 to January 2020 in our center were studied. Technical, hemodynamic, angiographic, and clinical outcome were recorded up to 1 year of follow-up. Results TIPS was attempted in 162 patients (median [range] age 37[3–69] years; 105 were males and 57 were females; Etiology: Budd-Chiari syndrome [BCS] 91, cirrhosis 65, symptomatic acute portal venous thrombosis [PVT] 3, veno-occlusive disease [VOD] 2, congenital portosystemic shunt [CPSS] 1) during the study period. Indication for TIPS was refractory ascites in 135 patients (BCS 86, cirrhosis 49) and variceal bleed in 21 patients (BCS 5, cirrhosis 16). Technical success was seen in 161 of the 162 (99.4%) patients. The tract was created from hepatic vein in 55 patients and inferior vena cava (IVC) in 106 patients. Complications within 1 week post TIPS were seen in 29 of the 162 (18%) patients, of whom one developed unexplained arrhythmia and hypotension and died. Of the patients with available follow-up, clinical success was noted in 120 (81%), while 14 (9%) patients had partial nonresponse and six (4%) had complete nonresponse. Eight (5%) patients died during the follow-up period. Conclusion The technical success of TIPS creation with additional transabdominal ultrasound guidance is very high with low peri-procedural complication rate. It has enabled the inclusion of a wider spectrum of cases like acute PVT and obliterated hepatic veins which were otherwise considered contraindications.
format	article
author	Shyamkumar N. Keshava Vinu Moses Anand Sharma Munawwar Ahmed Sathya Narayanan Aswin Padmanabhan Ashish Goel Uday Zachariah C.E. Eapen
author_facet	Shyamkumar N. Keshava Vinu Moses Anand Sharma Munawwar Ahmed Sathya Narayanan Aswin Padmanabhan Ashish Goel Uday Zachariah C.E. Eapen
author_sort	Shyamkumar N. Keshava
title	Technical and Medium-Term Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt with Fluoroscopy and Additional Trans-abdominal Ultrasound Guidance
title_short	Technical and Medium-Term Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt with Fluoroscopy and Additional Trans-abdominal Ultrasound Guidance
title_full	Technical and Medium-Term Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt with Fluoroscopy and Additional Trans-abdominal Ultrasound Guidance
title_fullStr	Technical and Medium-Term Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt with Fluoroscopy and Additional Trans-abdominal Ultrasound Guidance
title_full_unstemmed	Technical and Medium-Term Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt with Fluoroscopy and Additional Trans-abdominal Ultrasound Guidance
title_sort	technical and medium-term clinical outcomes of transjugular intrahepatic portosystemic shunt with fluoroscopy and additional trans-abdominal ultrasound guidance
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/63abb10ce3a843529c17a2c4ac838a7a
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Technical and Medium-Term Clinical Outcomes of Transjugular Intrahepatic Portosystemic Shunt with Fluoroscopy and Additional Trans-abdominal Ultrasound Guidance

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