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

作者：Tavare Aniket N^*; Wigham Andrew; Hadjivassilou Anastasia; Alvi Abdulrahman; Papadopoulou Anthie; Goode Antony; Woodward Nick; Patch David; Yu Dominic; Davies Neil

来源：Diagnostic and Interventional Radiology, 2017, 23(3): 206-210.

DOI：10.5152/dir.2016.15601

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 center dot cm(2), 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.

• 出版日期2017-6