TIPS-Impact of Experience on Procedural Efficiency and Safety

Area of Science:

• Interventional Radiology
• Hepatology
• Vascular Surgery

Background:

• Transjugular intrahepatic portosystemic shunt (TIPS) creation is a critical intervention for managing portal hypertension complications.
• Assessing the learning curve and impact of expertise on TIPS outcomes is essential for optimizing patient care and resource utilization.

Purpose of the Study:

• To evaluate the influence of operator experience and medical center expertise on the technical success and procedural efficiency of TIPS.
• To identify trends in procedural parameters over time and correlate them with operator experience.

Main Methods:

• Retrospective analysis of 245 TIPS procedures performed between 2017 and 2023 at a German tertiary hospital.
• Statistical methods including logistic and linear regressions, Mann-Whitney U, Chi-square, and Fisher's exact tests were employed to analyze data stratified by year and operator experience.

Main Results:

• Technical success rate for TIPS was high at 95.5% and remained stable over the study period.
• Significant reductions in total procedure time, fluoroscopy time, radiation dose, and contrast agent usage were observed from 2017 to 2023.
• More experienced operators demonstrated significantly shorter fluoroscopy times compared to less experienced operators.

Conclusions:

• TIPS is a technically successful procedure with consistently high success rates.
• Growing experience within a medical center correlates with improved procedural efficiency, including reduced procedure duration, radiation exposure, and contrast media consumption.
• Operator experience is a key factor in minimizing fluoroscopy time during TIPS procedures.