Analyzing Radiation Use during Transjugular Intrahepatic Portosystemic Shunt Creation

J Vasc Interv Radiol. 2020 Dec;31(12):2089-2097.e3. doi: 10.1016/j.jvir.2020.05.004. Epub 2020 Oct 3.

Abstract

Portal vein access during transjugular intrahepatic portosystemic shunt creation was examined in 11 patients. Radiation metrics (kerma area product, reference point air kerma, and fluoroscopy times) during portal vein access were significantly greater for conventional versus intravascular US-guided transjugular intrahepatic portosystemic shunt (54.8 mGy ∙ cm2 ± 27.6 vs 8.4 mGy ∙ cm2 ± 5.0, P = .009; 210.4 mGy ± 109.1 vs 29.5 mGy ± 18.4, P = .009; 19.1 min ± 8.6 vs 8.9 min ± 4.6, P = .04). Wedged hepatic venography is a major contributor to radiation exposure. Intravascular US guidance is associated with significantly reduced radiation use.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Phlebography / adverse effects*
  • Portal Vein / diagnostic imaging
  • Portal Vein / surgery*
  • Portasystemic Shunt, Transjugular Intrahepatic / adverse effects*
  • Radiation Dosage*
  • Radiation Exposure / adverse effects*
  • Radiation Exposure / prevention & control
  • Radiography, Interventional / adverse effects*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Ultrasonography, Interventional* / adverse effects