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- Title
Three-dimensional C-arm CT-guided transjugular intrahepatic portosystemic shunt placement: Feasibility, technical success and procedural time.
- Authors
Ketelsen, Dominik; Groezinger, Gerd; Maurer, Michael; Grosse, Ulrich; Horger, Marius; Nikolaou, Konstantin; Syha, Roland; Lauer, Ulrich; Lauer, Ulrich M
- Abstract
<bold>Objectives: </bold>Establishment of transjugular intrahepatic portosystemic shunts (TIPS) constitutes a standard procedure in patients suffering from portal hypertension. The most difficult step in TIPS placement is blind puncture of the portal vein. This study aimed to evaluate three-dimensional mapping of portal vein branches and targeted puncture of the portal vein.<bold>Methods: </bold>Twelve consecutive patients suffering from refractory ascites by liver cirrhosis were included in this retrospective study to evaluate feasibility, technical success and procedural time of C-arm CT-targeted puncture of the portal vein. As a control, 22 patients receiving TIPS placement with fluoroscopy-guided blind puncture were included to compare procedural time.<bold>Results: </bold>Technical success could be obtained in 100 % of the study group (targeted puncture) and in 95.5 % of the control group (blind puncture). Appropriate, three-dimensional C-arm CT-guided mapping of the portal vein branches could be achieved in all patients. The median number of punctures in the C-arm CT-guided study group was 2 ± 1.3 punctures. Procedural time was significantly lower in the study group (14.8 ± 8.2 min) compared to the control group (32.6 ± 22.7 min) (p = 0.02).<bold>Conclusions: </bold>C-arm CT-guided portal vein mapping is technically feasible and a promising tool for TIPS placement resulting in a significant reduction of procedural time.<bold>Key Points: </bold>• C-arm CT-mapping of the portal vein for 3D TIPS guidance is feasible. • Targeted punctures of the portal vein by C-arm CT reduce procedural time. • A decreased number of punctures could improve patient safety.
- Subjects
SURGICAL anastomosis; PORTAL hypertension; CIRRHOSIS of the liver; PORTAL vein; MEDICAL imaging systems; THREE-dimensional imaging; PATIENTS; PORTAL vein surgery; SURGICAL arteriovenous shunts; COMPUTED tomography; INTERVENTIONAL radiology; PILOT projects; TREATMENT effectiveness; RETROSPECTIVE studies; EQUIPMENT &; supplies
- Publication
European Radiology, 2016, Vol 26, Issue 12, p4277
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-016-4340-4