[Ultrasound guided puncture of the portal vein in transjugular intrahepatic portasystemic stent shunt (TIPSS)].
Successful completion of a transjugular intrahepatic portosystemic stentshunt (TIPSS) relies on knowledge of the individual hepatic vascular anatomy. The patients referred for TIPSS have an increased risk of contrast-medium-induced renal failure, and therefore the potential for a complete angiographic work-up during the procedure is limited. The same patient population also carries an increased risk of bleeding, which necessitates a rather accurate guiding technique for portal punctures. We have established transcutaneous sonographic guidance as a standard technique for transjugular portal puncture, reducing complication rates and intervention time. Competing imaging modalities for guidance are discussed.
Roeren
T
T
Abteilung Radiodiagnostik, Radiologische Universitätsklinik Heidelberg.
Richter
G M
GM
Limberg
B
B
Jacoby
I R
IR
Kauffmann
G W
GW
D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000601:surgery; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000601:surgery; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000295:instrumentation*; D011677:Punctures / Q000295:instrumentation*; D013525:Surgical Instruments; D016896:Treatment Outcome; D014463:Ultrasonography