3D C-Arm cone beam CT for targeting the portal vein during TIPS: Initial clinical experience. Issue 106 (September 2018)

• Record Type: Journal Article
• Authors: Chivot, Cyril; Robert, Brice; Bouzerar, Roger; Popoff, Romain; Yzet, Thierry
• Is Part Of: European journal of radiology. Issue 106(2018)
• Page Start: 20
• Page End: 25
• Publication Date: 2018-09
• Subjects: CBCT cone beam computed tomography -- 3D CBCT Three dimensional cone beam computed tomography -- TIPS transjugular intrahépatic portosystemic shunt -- VTR volume rendering technique -- 3D Three dimensional -- DAP dose area Product -- Ka Air kerma -- FT fluoroscopy time -- CO2 carbon dioxide -- CT computed tomography -- MRI magnetic resonance imaging; TIPS -- Indirect portograph -- Cone beam ct -- Roadmap 3D; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2018.06.025
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: 3Dcone beam ct helps to target the portal vein during TIPS. This new injection protocol allowed getting a good quality 3D Road map. 3D Road map decrease the rate of failure during TIPS. Abstract: Purpose: To evaluate the feasibility, safety and usefulness of 3D CBCT with a new injection protocol for targeting the portal vein during TIPS and to determine if it allows decreasing the duration of the procedure. Materials and methods: 3D CBCT was obtained during creation of TIPS in 15 patients (group 2). Portogram quality score was defined using a 5 points scale. The time required to achieve portal puncture was also recorded and results were compared retrospectively in 15 patients who underwent TIPS without 3D CBCT (group 1). Results: The mean time required to puncture the portal vein was shorter when CBCT was used: 15 min versus 24 min (p = 0.156). We recorded 3 failures requiring a second procedure in group 1. There were no complications and no failure in group 2. We recorded 93% of good portography and 80% of good 3D roadmaps. Conclusion: 3D CBCT coupled with this new injection protocol provided high rate of good quality portography allowing to bring positional and directional information to improve the needle pass efficiency and to decrease the duration of the procedure.