Ni Zhao , Anya Shi , Weile Huang , Jianan He , Dashuai Wang , Yongyu Zhang , Hui Guo , Bin Zhou , Hairun Gan , Pengfei Pang
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Baseline characteristics, clinical outcomes, and procedural data were analyzed.</div></div><div><h3>Results</h3><div>Technical success was achieved in 35 conventional TIPS patients (92.11 %), 20 CT-fluoroscopy image fusion-guided TIPS patients (95.24 %), and 26 transabdominal US-guided TIPS patients (96.30 %). Among patients who underwent a successful procedure, the procedural time and contrast usage were lower in the CT-fluoroscopy image fusion-guided and <em>trans</em>-abdominal US-guided TIPS groups than in the conventional group. There was a statistical significance in the cumulative fluoroscopic time between CT-fluoroscopy image fusion-guided TIPS and conventional TIPS groups (43.19 ± 14.92 vs 63.05 ± 30.33 min, <em>p = 0.012</em>). No immediate experienced complications were observed. Furthermore, the incidence of post-procedural complications among the three groups was not statistically different during follow-up.</div></div><div><h3>Conclusions</h3><div>CT-fluoroscopy image fusion and <em>trans</em>-abdominal US-guided portal vein cannulation are feasible, safe, and effective adjunct methods for patients undergoing TIPS. These methods provide shorter procedural time and lower contrast usage for TIPS placement.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"183 ","pages":"Article 111875"},"PeriodicalIF":3.2000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Three-dimensional volumetric CT image fusion and trans-abdominal US: Adjunct guidance to portal vein cannulation for TIPS\",\"authors\":\"Ni Zhao , Anya Shi , Weile Huang , Jianan He , Dashuai Wang , Yongyu Zhang , Hui Guo , Bin Zhou , Hairun Gan , Pengfei Pang\",\"doi\":\"10.1016/j.ejrad.2024.111875\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>To describe portal vein cannulation under adjunct guidance for transjugular intrahepatic portosystemic shunts (TIPS).</div></div><div><h3>Methods</h3><div>Medical records of 86 patients who underwent TIPS, including conventional TIPS, 3D volumetric CT image fusion (CT-fluoroscopy image fusion)-guided TIPS, and <em>trans</em>-abdominal ultrasound (US)-guided TIPS at our institute from March 2016 to June 2024 were reviewed. Baseline characteristics, clinical outcomes, and procedural data were analyzed.</div></div><div><h3>Results</h3><div>Technical success was achieved in 35 conventional TIPS patients (92.11 %), 20 CT-fluoroscopy image fusion-guided TIPS patients (95.24 %), and 26 transabdominal US-guided TIPS patients (96.30 %). Among patients who underwent a successful procedure, the procedural time and contrast usage were lower in the CT-fluoroscopy image fusion-guided and <em>trans</em>-abdominal US-guided TIPS groups than in the conventional group. There was a statistical significance in the cumulative fluoroscopic time between CT-fluoroscopy image fusion-guided TIPS and conventional TIPS groups (43.19 ± 14.92 vs 63.05 ± 30.33 min, <em>p = 0.012</em>). No immediate experienced complications were observed. Furthermore, the incidence of post-procedural complications among the three groups was not statistically different during follow-up.</div></div><div><h3>Conclusions</h3><div>CT-fluoroscopy image fusion and <em>trans</em>-abdominal US-guided portal vein cannulation are feasible, safe, and effective adjunct methods for patients undergoing TIPS. 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引用次数: 0
摘要
目的：探讨在辅助指导下门静脉插管治疗经颈静脉肝内门静脉系统分流术（TIPS）。方法：回顾我院2016年3月至2024年6月行常规TIPS、三维体积CT图像融合（CT-透视图像融合）引导下TIPS、经腹超声（US）引导下TIPS的86例患者的病历。分析基线特征、临床结果和手术数据。结果：常规TIPS 35例（92.11%），ct -透视图像融合引导TIPS 20例（95.24%），经腹us引导TIPS 26例（96.30%）技术成功。在手术成功的患者中，ct -透视图像融合引导和经腹us引导的TIPS组的手术时间和造影剂使用低于常规组。ct -透视影像融合引导下TIPS组与常规TIPS组的累积透视时间比较，差异有统计学意义（43.19±14.92 vs 63.05±30.33 min, p = 0.012）。没有观察到直接的并发症。随访期间，三组患者术后并发症发生率无统计学差异。结论：ct -透视影像融合及经腹us引导门静脉插管是TIPS患者可行、安全、有效的辅助方法。这些方法为TIPS放置提供了更短的操作时间和更低的对比度使用。
Three-dimensional volumetric CT image fusion and trans-abdominal US: Adjunct guidance to portal vein cannulation for TIPS
Purpose
To describe portal vein cannulation under adjunct guidance for transjugular intrahepatic portosystemic shunts (TIPS).
Methods
Medical records of 86 patients who underwent TIPS, including conventional TIPS, 3D volumetric CT image fusion (CT-fluoroscopy image fusion)-guided TIPS, and trans-abdominal ultrasound (US)-guided TIPS at our institute from March 2016 to June 2024 were reviewed. Baseline characteristics, clinical outcomes, and procedural data were analyzed.
Results
Technical success was achieved in 35 conventional TIPS patients (92.11 %), 20 CT-fluoroscopy image fusion-guided TIPS patients (95.24 %), and 26 transabdominal US-guided TIPS patients (96.30 %). Among patients who underwent a successful procedure, the procedural time and contrast usage were lower in the CT-fluoroscopy image fusion-guided and trans-abdominal US-guided TIPS groups than in the conventional group. There was a statistical significance in the cumulative fluoroscopic time between CT-fluoroscopy image fusion-guided TIPS and conventional TIPS groups (43.19 ± 14.92 vs 63.05 ± 30.33 min, p = 0.012). No immediate experienced complications were observed. Furthermore, the incidence of post-procedural complications among the three groups was not statistically different during follow-up.
Conclusions
CT-fluoroscopy image fusion and trans-abdominal US-guided portal vein cannulation are feasible, safe, and effective adjunct methods for patients undergoing TIPS. These methods provide shorter procedural time and lower contrast usage for TIPS placement.
期刊介绍：
European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field.
Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.
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