Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Use of transabdominal ultrasound-guided transjugular portal vein puncture on radiation dose in transjugular intrahepatic portosystemic shunt formation


Department of Radiology, Royal Free London NHS Foundation Trust, London, UK


Department of Radiology, Oxford University Hospitals NHS Trust, Oxford, UK


Department of Hepatology, Royal Free London NHS Foundation Trust, London, UK

Diagn Interv Radiol 2017; 23: 206-210
DOI: 10.5152/dir.2016.15601
Read: 612 Downloads: 252 Published: 03 September 2019


PURPOSE: Transjugular intrahepatic portosystemic shunt (TIPS) creation is used to treat portal hypertension complications. Often the most challenging and time-consuming step in the procedure is the portal vein (PV) puncture. TIPS procedures are associated with prolonged fluoroscopy time and high patient radiation exposures. We measured the impact of transabdominal ultrasound guidance for PV puncture on duration of fluoroscopy time and dose.


METHODS: We retrospectively analyzed the radiation dose for all TIPS performed over a four-year period with transabdominal ultrasound guidance for PV puncture (n=212, with 210 performed successfully and data available for 206); fluoroscopy time, dose area product (DAP) and skin dose were recorded.


RESULTS: Mean fluoroscopy time was 12 min 9 s (SD, ±14 min 38 s), mean DAP was 40.3±73.1 Gy·cm2, and mean skin dose was 404.3±464.8 mGy.


CONCLUSION: Our results demonstrate that ultrasound-guided PV puncture results in low fluoroscopy times and radiation doses, which are markedly lower than the only published dose reference levels.

EISSN 1305-3612