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Three-dimensional path planning software-assisted transjugular intrahepatic portosystemic shunt: a technical

Jiaywei Tsauo¹, Xuefeng Luo, Linchao Ye

¹Institute of Interventional Radiology, West China Hospital of Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan, China, 80732059@qq.com.

Cardiovascular and Interventional Radiology

|June 18, 2014

Summary

A modified three-dimensional (3D) path planning software technique improved transjugular intrahepatic portosystemic shunt (TIPS) procedures. Adjusting the liver access angle to match the 3D path angle led to successful portal vein access in most patients.

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Area of Science:

Interventional Radiology
Medical Imaging
Hepatology

Background:

Transjugular intrahepatic portosystemic shunt (TIPS) creation is a complex interventional radiology procedure.
Three-dimensional (3D) path planning software has been developed to aid TIPS needle guidance.
A limitation of existing 3D software is the potential misalignment between the planned path and the actual liver access angle.

Purpose of the Study:

To report the outcomes of a modified technique for 3D path planning software-assisted TIPS.
To address the technical challenge of angle misalignment in 3D-guided TIPS procedures.

Main Methods:

A prototype 3D path planning software was enhanced with a utility to calculate the 3D path angle.
The liver access angle was adjusted to match the calculated 3D path angle in ten patients undergoing TIPS.
Two carbon dioxide portograms were used to generate the 3D path for needle guidance.

Main Results:

The modified technique was successful in seven out of ten patients.
Portal vein access was achieved in a single needle pass in all successful procedures.
The puncture course accurately followed the 3D planned path, with no procedure-related complications observed.

Conclusions:

Modifying the liver access angle to align with the 3D path angle is a beneficial enhancement for 3D path planning software-assisted TIPS.
This adjusted technique improves the feasibility and success rate of 3D-guided TIPS procedures.