We have located links that may give you full text access.
Modified gun-sight transjugular intrahepatic portosystemic shunt technique.
British Journal of Radiology 2022 September 6
OBJECTIVES: Conventional transjugular intrahepatic portosystemic shunt (TIPS) stent insertion is an established procedure with high rates of technical success. However, alternative techniques may increase success rates in the setting of challenging anatomy or limited resources. Originally described as a salvage porto-caval approach, we present a modified gun-sight porto-hepatic TIPS technique.
METHODS: A retrospective review was performed identifying patients who underwent modified gun-sight TIPS over a 1 year period. Six procedures were identified, with snares opened in the target hepatic and portal veins, fluoroscopic percutaneous transhepatic puncture through the snares, and wire pulled through-and-through to establish a parenchymal tract. Five modified gun-sight procedures were primary, and one was salvage.
RESULTS: All modified gun-sight TIPS procedures were technically successful with a single needle pass, with patency and appropriate haemodynamic flow at 2 weeks. Advantages of the technique include fluoroscopic-guided transhepatic puncture utilising typically on-shelf low-cost equipment, without requiring a dedicated TIPS set or endovascular ultrasound. Disadvantages include liver capsular puncture.
CONCLUSIONS: The modified gun-sight TIPS technique is an alternative approach utilising typically on-shelf and low-cost equipment for a targeted fluoroscopic-guided parenchymal puncture.
ADVANCES IN KNOWLEDGE: The presented technique is an initial description of a novel alternative TIPS technique, which may be useful to consider in challenging cases.
METHODS: A retrospective review was performed identifying patients who underwent modified gun-sight TIPS over a 1 year period. Six procedures were identified, with snares opened in the target hepatic and portal veins, fluoroscopic percutaneous transhepatic puncture through the snares, and wire pulled through-and-through to establish a parenchymal tract. Five modified gun-sight procedures were primary, and one was salvage.
RESULTS: All modified gun-sight TIPS procedures were technically successful with a single needle pass, with patency and appropriate haemodynamic flow at 2 weeks. Advantages of the technique include fluoroscopic-guided transhepatic puncture utilising typically on-shelf low-cost equipment, without requiring a dedicated TIPS set or endovascular ultrasound. Disadvantages include liver capsular puncture.
CONCLUSIONS: The modified gun-sight TIPS technique is an alternative approach utilising typically on-shelf and low-cost equipment for a targeted fluoroscopic-guided parenchymal puncture.
ADVANCES IN KNOWLEDGE: The presented technique is an initial description of a novel alternative TIPS technique, which may be useful to consider in challenging cases.
Full text links
Related Resources
Trending Papers
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities.Diabetologia 2024 April 17
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Eosinophilic Esophagitis: Clinical Pearls for Primary Care Providers and Gastroenterologists.Mayo Clinic Proceedings 2024 April
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app