Related Experiment Video
Updated: Jul 30, 2026
Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt
Published on: May 7, 2015
Transjugular intrahepatic portosystemic shunt creation using a three-dimensional fluoroscopy guidance system in
Bruce M Bell1, Marco Cura1, Cathryn J Shaw1
1Department of Radiology, Baylor University Medical Center at Dallas.
Insights
Transjugular intrahepatic portosystemic shunt (TIPS) creation for Budd-Chiari syndrome (BCS) is challenging. A novel 3D fluoroscopy guidance system, using CT imaging to create a virtual needle path, improved TIPS procedures in BCS patients.
Area of Science:
- Interventional Radiology
- Medical Imaging
- Hepatology
Background:
- Transjugular intrahepatic portosystemic shunt (TIPS) creation is a complex procedure for Budd-Chiari syndrome (BCS).
- Hepatic congestion and asymmetric hypertrophy in BCS present significant technical challenges during TIPS creation.
- Existing methods may lack precision in navigating complex intrahepatic anatomy.
Abstract:
When performed for Budd-Chiari syndrome (BCS), transjugular intrahepatic portosystemic shunt (TIPS) creation can be technically difficult due to hepatic congestion and asymmetric hypertrophy. We present three female patients with decompensated BCS in whom TIPS were created using a three-dimensional fluoroscopy guidance system. On a dedicated workstation using three-dimensional volumes of computed tomography imaging, a virtual needle path was created by the operator extending from the needle entry point (hepatic vein stump or inferior vena cava) to the target portal vein. Subsequently, the virtual needle path was overlaid on the fluoroscopy image for guidance of portal venous cannulation. This technology can be used for TIPS procedures in patients with BCS and other complex TIPS cases, as it may help delimit the trajectory of the needle pass and optimally result in more efficient procedures with decreased radiation dose.
