Safety and feasibility of a novel bi-directional portal vein access kit during transjugular intrahepatic portosystemic shunt creation
Abstract Background Transjugular 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 ra...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-04-01
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| Series: | CVIR Endovascular |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42155-023-00366-x |
| _version_ | 1797840775036272640 |
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| author | Richard D. Kang Nariman Nezami Peter Park Anthony A. DePalma Mohammed F. Loya Rahul Mhaskar Chad Engel Bruce Zwiebel Glenn Hoots Jamil Shaikh |
| author_facet | Richard D. Kang Nariman Nezami Peter Park Anthony A. DePalma Mohammed F. Loya Rahul Mhaskar Chad Engel Bruce Zwiebel Glenn Hoots Jamil Shaikh |
| author_sort | Richard D. Kang |
| collection | DOAJ |
| description | Abstract Background Transjugular 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 methods In 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). Results Portal 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. Conclusions Clinical 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 evidence Retrospective cohort. |
| first_indexed | 2024-04-09T16:20:10Z |
| format | Article |
| id | doaj.art-3bd74ea58d3042bea8beb12fafe44128 |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-04-09T16:20:10Z |
| publishDate | 2023-04-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-3bd74ea58d3042bea8beb12fafe441282023-04-23T11:29:28ZengSpringerOpenCVIR Endovascular2520-89342023-04-01611710.1186/s42155-023-00366-xSafety and feasibility of a novel bi-directional portal vein access kit during transjugular intrahepatic portosystemic shunt creationRichard D. Kang0Nariman Nezami1Peter Park2Anthony A. DePalma3Mohammed F. Loya4Rahul Mhaskar5Chad Engel6Bruce Zwiebel7Glenn Hoots8Jamil Shaikh9University of South Florida, Morsani College of MedicineDivision of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of MedicineEmory University, School of Medicine, Department of Radiology and Image Guided MedicineEmory University, School of Medicine, Department of Radiology and Image Guided MedicineMid-Atlantic Permanente Medical GroupUniversity of South Florida, Morsani College of MedicineUniversity of South Florida, Morsani College of MedicineUniversity of South Florida, Morsani College of MedicineUniversity of South Florida, Morsani College of MedicineUniversity of South Florida, Morsani College of MedicineAbstract Background Transjugular 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 methods In 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). Results Portal 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. Conclusions Clinical 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 evidence Retrospective cohort.https://doi.org/10.1186/s42155-023-00366-xPortal hypertensionTIPSBi-directionalPortal vein access |
| spellingShingle | Richard D. Kang Nariman Nezami Peter Park Anthony A. DePalma Mohammed F. Loya Rahul Mhaskar Chad Engel Bruce Zwiebel Glenn Hoots Jamil Shaikh Safety and feasibility of a novel bi-directional portal vein access kit during transjugular intrahepatic portosystemic shunt creation CVIR Endovascular Portal hypertension TIPS Bi-directional Portal vein access |
| title | Safety and feasibility of a novel bi-directional portal vein access kit during transjugular intrahepatic portosystemic shunt creation |
| title_full | Safety and feasibility of a novel bi-directional portal vein access kit during transjugular intrahepatic portosystemic shunt creation |
| title_fullStr | Safety and feasibility of a novel bi-directional portal vein access kit during transjugular intrahepatic portosystemic shunt creation |
| title_full_unstemmed | Safety and feasibility of a novel bi-directional portal vein access kit during transjugular intrahepatic portosystemic shunt creation |
| title_short | Safety and feasibility of a novel bi-directional portal vein access kit during transjugular intrahepatic portosystemic shunt creation |
| title_sort | safety and feasibility of a novel bi directional portal vein access kit during transjugular intrahepatic portosystemic shunt creation |
| topic | Portal hypertension TIPS Bi-directional Portal vein access |
| url | https://doi.org/10.1186/s42155-023-00366-x |
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