Analyzing Radiation Use during Transjugular Intrahepatic Portosystemic Shunt Creation |
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Affiliation: | 1. Department of Clinical Sciences, University of Central Florida College of Medicine, Orlando, Florida;2. Interventional Radiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Boulevard, St. Louis, MO 63110;1. Department of General Surgery, Saint Joseph Hospital, 1375 E. 19th Ave., Denver, CO 80218;2. Department of Vascular Therapy and Interventional Radiology, Colorado Permanente Medical Group, 2045 Franklin St., Denver, CO 80205;1. Neurointerventional and Interventional Vascular Unit, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;2. Service de Réanimation, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;3. Service de Radiologie, Hôpital Pasteur 2, University of Nice, 30 voie Romaine, Nice 06000, France;1. Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan;2. Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan;3. Kansai Rosai Hospital Cardiovascular Center, Amagasaki, Hyogo, Japan |
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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. |
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