title: A new coaxial needle system, hepatic artery targeting wire, and biplane fluoroscopy to increase safety and efficacy of TIPS.
abstract: To improve safety and efficacy of the transjugular intrahepatic portosystemic shunt (TIPS) procedure, we introduced a new, thin-needle (21-gauge long PTC needle) puncture technique using biplane fluoroscopy and targeting of a guidewire tip in the right hepatic artery. After puncture of the right portal vein, a 0.016-inch guidewire was inserted into the portal vein, followed by a 4 Fr dilator. The 4 Fr dilator allowed introduction of a 0.035-inch working guidewire. We successfully performed TIPS in seven patients with postnecrotic cirrhosis using this technique and encountered no technical difficulties or complications.
authors.affiliation: Department of Radiology, Kanazawa University School of Medicine, Japan.
authors.forename: O
authors.initials: O
authors.lastname: Matsui
authors.forename: M
authors.initials: M
authors.lastname: Kadoya
authors.forename: J
authors.initials: J
authors.lastname: Yoshikawa
authors.forename: T
authors.initials: T
authors.lastname: Gabata
authors.forename: S
authors.initials: S
authors.lastname: Miyayama
authors.forename: T
authors.initials: T
authors.lastname: Takashima
mesh_terms: D005471:Fluoroscopy / Q000295:instrumentation / Q000379:methods*; D006499:Hepatic Artery; D006801:Humans; D009339:Needles; D011170:Portasystemic Shunt, Surgical / Q000295:instrumentation*; D015641:Radiography, Interventional / Q000295:instrumentation*