title: Novel Image Guidance Techniques for Portal Vein Targeting During Transjugular Intrahepatic Portosystemic Shunt Creation.
abstract: The most challenging part of transjugular intrahepatic portosystemic shunt creation is arguably the transvenous access from the hepatic vein to the portal vein. As experience and technology have evolved, the image guidance aspect of this critical step in the procedure has become more robust. Improved means to target the portal vein include both direct and indirect methods of portal vein opacification, cross-sectional imaging for both targeting and access, and novel use of transabdominal and intravascular ultrasound guidance. These techniques are described herein.
authors.affiliation: Dotter Interventional Institute, Oregon Health and Science University, Portland, OR. Electronic address: farsad@ohsu.edu.
authors.forename: Khashayar
authors.initials: K
authors.lastname: Farsad
authors.affiliation: Dotter Interventional Institute, Oregon Health and Science University, Portland, OR.
authors.forename: John A
authors.initials: JA
authors.lastname: Kaufman
mesh_terms: D000072226:Computed Tomography Angiography; D005471:Fluoroscopy; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D018810:Magnetic Resonance Angiography; D053783:Magnetic Resonance Imaging, Interventional; D010690:Phlebography; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000601:surgery*; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects / Q000379:methods*; D011172:Portography; D015641:Radiography, Interventional; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: Intravascular ultrasound; image guidance; portal vein; portography; transjugular intrahepatic portosystemic shunt