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Doppler ultrasound for TIPS: does it work?

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Abstract

The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of complications of portal hypertension such as variceal hemorrhage and ascites is well established. However, TIPS has a limited patency due to dysfunction consisting in occlusion stenosis of the intrahepatic tract or stenosis of the outflow hepatic vein. Timing of dysfunction cannot be predicted, so routine surveillance and percutaneous intervention are continuously required to maintain TIPS patency. Trans-shunt venography is the gold standard technique in TIPS evaluation, but it is expensive and invasive. Doppler ultrasound (DU) has been the most commonly used noninvasive tool in TIPS patency. Despite many reported series, its role remains controversial. After more than 10 years of experience with TIPS, we followed our patients with DU and trans-shunt venography to establish Doppler criteria of dysfunction and its accuracy in assessing shunt dysfunction.

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Acknowledgements

The authors thank Jesus Longo, MD, PhD, from Centro Médico de Asturias (Oviedo, Spain), for his initial and invaluable contribution to the development of Doppler US in the placement and follow-up of patients with TIPS in our hospital.

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Benito, A., Bilbao, J., Hernández, T. et al. Doppler ultrasound for TIPS: does it work? . Abdom Imaging 29, 45–52 (2004). https://doi.org/10.1007/s00261-003-0088-9

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