{"title":"Intravascular Ultrasound (IVUS) in Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation: A Systematic Review and Meta-Analysis Comparing Conventional TIPS with IVUS-Guided TIPS.","authors":"Pooya Torkian, Reza Talaie, Siobhan Flanagan, Ashkan Heshmatzadeh Behzadi","doi":"10.1093/bjr/tqaf158","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review and meta-analysis evaluate the clinical and procedural benefits of intravascular ultrasound (IVUS)-guided portal vein access during transjugular intrahepatic portosystemic shunt (iTIPS) creation compared to the conventional TIPS (cTIPS) technique.</p><p><strong>Methods: </strong>A comprehensive search of Medline and Google Scholar through August 30, 2024, was conducted to identify retrospective studies comparing iTIPS and cTIPS. A total of six studies, involving 418 patients (180 undergoing iTIPS and 238 undergoing cTIPS), met inclusion criteria. Matched comparison groups were used to analyze outcomes.</p><p><strong>Results: </strong>Technical success rates were similar between iTIPS and cTIPS groups. One study reported a significantly lower complication rate with iTIPS, while three studies found no differences in complications. Notably, iTIPS significantly reduced fluoroscopy time by 9.74 minutes (p < 0.001) and radiation exposure by 583.4 mGy (p < 0.001) compared to cTIPS. The total procedure time and portal venous access time were shorter by 21 minutes (p < 0.001) and 15.49 minutes (p < 0.001), respectively, with IVUS guidance. Additionally, contrast agent use was 69.62 cc lower (p < 0.001) in iTIPS cases.</p><p><strong>Conclusion: </strong>Although based on a limited number of studies, these findings support IVUS-guided TIPS as a superior technique for improving procedural efficiency and reducing radiation exposure, procedure times, and contrast agent usage without compromising success rates. Its benefits are particularly pronounced in patients with complex anatomy or heightened risk factors.</p><p><strong>Advances in knowledge: </strong>IVUS-guided TIPS demonstrates potential procedural and safety advantages over conventional techniques, particularly in anatomically complex or high-risk patients. These findings support further investigation and prospective validation.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bjr/tqaf158","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: This systematic review and meta-analysis evaluate the clinical and procedural benefits of intravascular ultrasound (IVUS)-guided portal vein access during transjugular intrahepatic portosystemic shunt (iTIPS) creation compared to the conventional TIPS (cTIPS) technique.
Methods: A comprehensive search of Medline and Google Scholar through August 30, 2024, was conducted to identify retrospective studies comparing iTIPS and cTIPS. A total of six studies, involving 418 patients (180 undergoing iTIPS and 238 undergoing cTIPS), met inclusion criteria. Matched comparison groups were used to analyze outcomes.
Results: Technical success rates were similar between iTIPS and cTIPS groups. One study reported a significantly lower complication rate with iTIPS, while three studies found no differences in complications. Notably, iTIPS significantly reduced fluoroscopy time by 9.74 minutes (p < 0.001) and radiation exposure by 583.4 mGy (p < 0.001) compared to cTIPS. The total procedure time and portal venous access time were shorter by 21 minutes (p < 0.001) and 15.49 minutes (p < 0.001), respectively, with IVUS guidance. Additionally, contrast agent use was 69.62 cc lower (p < 0.001) in iTIPS cases.
Conclusion: Although based on a limited number of studies, these findings support IVUS-guided TIPS as a superior technique for improving procedural efficiency and reducing radiation exposure, procedure times, and contrast agent usage without compromising success rates. Its benefits are particularly pronounced in patients with complex anatomy or heightened risk factors.
Advances in knowledge: IVUS-guided TIPS demonstrates potential procedural and safety advantages over conventional techniques, particularly in anatomically complex or high-risk patients. These findings support further investigation and prospective validation.
期刊介绍：
BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences.
Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896.
Quick Facts:
- 2015 Impact Factor – 1.840
- Receipt to first decision – average of 6 weeks
- Acceptance to online publication – average of 3 weeks
- ISSN: 0007-1285
- eISSN: 1748-880X
Open Access option
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
