Document Detail


Ultrasound-guided transhepatic puncture of the hepatic veins for TIPS placement.
MedLine Citation:
PMID:  22744357     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: This retrospective analysis was carried out to assess the feasibility and results of transjugular intrahepatic portal systemic shunt (TIPS) performed with ultrasound (US)-guided percutaneous puncture of the hepatic veins. MATERIAL AND METHODS: Over a period of 3 years, 153 patients were treated with TIPS at our centre. In eight cases, a percutaneous puncture of the middle (n=7) or right (n=1) hepatic vein was required because the hepatic vein ostium was not accessible. Indications for TIPS were bleeding (n=1), Budd-Chiari syndrome (n=1), ascites (n=2), reduced portal flow (n=1) and incomplete portal thrombosis (n=3). A 0.018-in. guidewire was anterogradely introduced into the hepatic vein to the inferior vena cava (IVC) through a 21-gauge needle. In the meantime, a 25-mm snare-loop catheter was introduced through the jugular access to retrieve the guidewire, achieving through-andthrough access. Then, a Rosch-Uchida set was used to place the TIPS with the traditional technique. RESULTS: Technical success was achieved in all patients. There was one case of stent thrombosis. One patient died of pulmonary oedema. Three patients were eligible for liver transplantation, whereas the others were excluded due to shunt thrombosis (n=1) and previous nonhepatic neoplasms (n=3). CONCLUSIONS: The percutaneous approach to hepatic veins is rapid and safe and may be useful for avoiding traumatic liver injuries.
Authors:
C Gazzera; P Fonio; C Gallesio; F Camerano; A Doriguzzi Breatta; D Righi; A Veltri; G Gandini
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-28
Journal Detail:
Title:  La Radiologia medica     Volume:  -     ISSN:  1826-6983     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0177625     Medline TA:  Radiol Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Istituto di Radiologia, Università degli Studi di Torino, Ospedale S. Giovanni Battista di Torino, Via Genova 3, 10126, Torino, Italy.
Vernacular Title:
Puntura transepatica ecoguidata delle vene sovraepatiche per il confezionamento della TIPS.
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