MR Angiographic guidance for transjugular intrahepatic portosystemic shunt procedures
- 1 March 1994
- journal article
- research article
- Published by Wiley in Journal of Magnetic Resonance Imaging
- Vol. 4 (2), 145-150
- https://doi.org/10.1002/jmri.1880040208
Abstract
The authors used magnetic resonance (MR) angiography to guide catheter placement in transjugular intrahepatic portosystemic shunt (TIPS) procedures in nine of 18 patients and compared the results with those of the nine patients for whom prior planning based on MR angiography was not done. Two-dimensional time-of-flight MR venography was performed during breath hold, and projection venograms were formatted in sagittal, coronal, and axial planes. MR angiography defined venous anatomy sufficiently to shorten the procedure and help minimize invasiveness. With MR angiographic guidance, intrahepatic needle punctures were significantly fewer (without MR guidance: mean, 12.1; with MR guidance: mean, 3.6; P < 0.001) and associated complications were absent (without MR guidance: failed placement, n = 1; bleeding requiring blood transfusions, n = 1; death due to intraperitoneal hemorrhage with hemobilia, n = 1; and death due to hepatic capsular perforation, n = 1). The average time for the procedure was 2.9 hours without MR angiographic guidance and 1.8 hours with MR angiographic guidance (P < 0.001). The authors conclude that MR angiography is a useful technique for defining portal and hepatic venous anatomy before the TIPS procedure and that planning based on MR angiography may decrease the difficulty and length of the procedure.This publication has 20 references indexed in Scilit:
- US-guided Paraumbilical Vein Puncture: An Adjunct to Transjugular Intrahepatic Portosystemic Shunt (TIPS) PlacementJournal of Vascular and Interventional Radiology, 1992
- Localization of the Portal Vein for Transjugular Catheterization: Percutaneous Placement of a Metallic Marker with Real-Time US GuidanceJournal of Vascular and Interventional Radiology, 1992
- Percutaneous transjugular portosystemic shunt: Commentary on the technical aspects of this new procedureJournal of Hepatology, 1992
- Abdominal Magnetic Resonance VenographyCardioVascular and Interventional Radiology, 1992
- MR angiography and dynamic flow evaluation of the portal venous systemAmerican Journal of Roentgenology, 1989
- Expandable intrahepatic portacaval shunt stents in dogs with chronic portal hypertensionAmerican Journal of Roentgenology, 1986
- Formation of intrahepatic portosystemic shunts using a balloon dilatation catheter: preliminary clinical experienceAmerican Journal of Roentgenology, 1983
- Transjugular Portal Venography and Radiologic Portacaval Shunt: An Experimental StudyRadiology, 1969