Safety and feasibility of a novel bi-directional portal vein access kit during transjugular intrahepatic portosystemic shunt creation

CVIR Endovascular

卷:6

Original Article

Nariman Nezami¹  Peter Park²  Anthony A. DePalma²  Mohammed F. Loya³  Richard D. Kang⁴  Rahul Mhaskar⁴  Chad Engel⁵  Jamil Shaikh⁵  Glenn Hoots⁵  Bruce Zwiebel⁵ 

[1] Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA;Experimental Therapeutics Program, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA;

[2] Emory University, School of Medicine, Department of Radiology and Image Guided Medicine, Atlanta, GA, USA;

[3] Mid-Atlantic Permanente Medical Group, Kaiser Permanente, Rockville, MD, USA;

[4] University of South Florida, Morsani College of Medicine, Tampa, FL, USA;

[5] University of South Florida, Morsani College of Medicine, Tampa, FL, USA;Department of Radiology, University of South Florida Health, Tampa General Hospital, Tampa, FL, USA;

关键词: Portal hypertension;    TIPS;    Bi-directional;    Portal vein access;   

DOI  :  10.1186/s42155-023-00366-x

 received in 2022-12-08, accepted in 2023-03-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTransjugular intrahepatic portosystemic shunt (TIPS) creation remains as one of the more technically challenging endovascular procedures. Portal vein access from the hepatic vein often requires multiple needle passes, which increases procedure times, risk of complications, and radiation exposure. With its bi-directional maneuverability, the Scorpion X access kit may be a promising tool for easier portal vein access. However, the clinical safety and feasibility of this access kit has yet to be determined.Materials and methodsIn this retrospective study, 17 patients (12 male, average age 56.6 ± 9.01) underwent TIPS procedure using Scorpion X portal vein access kits. The primary endpoint was time taken to access the portal vein from the hepatic vein. The most common indications for TIPS were refractory ascites (47.1%) and esophageal varices (17.6%). Radiation exposure, total number of needle passes, and intraoperative complications were recorded. Average MELD Score was 12.6 ± 3.39 (range: 8–20).ResultsPortal vein cannulation was successfully achieved in 100% of patients during intracardiac echocardiography-assisted TIPS creation. Total fluoroscopy time was 39.31 ± 17.97 min; average radiation dose was 1036.76 ± 644.15 mGy, while average contrast dose was 120.59 ± 56.87 mL. The average number of passes from the hepatic vein to the portal vein was 2 (range: 1–6). Average time to access the portal vein once the TIPS cannula was positioned in the hepatic vein was 30.65 ± 18.64 min. There were no intraoperative complications.ConclusionsClinical utilization of the Scorpion X bi-directional portal vein access kit is both safe and feasible. Utilizing this bi-directional access kit resulted in successful portal vein access with minimal intraoperative complications.Level of evidenceRetrospective cohort.

【 授权许可】

CC BY   
© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023

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