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[After-care of TIPSS patients. Comparison between color Doppler ultrasound and portography]
M Libicher1, B Radeleff, U Mädler
1Abteilung Radiodiagnostik, Radiologische Universitätsklinik, Heidelberg.
Purpose:
Comparison of color Doppler sonography and venous portography in patients with a transjugular intrahepatic portosystemic stent shunt (TIPSS).
Materials And Methods:
In a prospective study 40 consecutive patients with TIPSS underwent venous portography and color Doppler sonography on the same day as follow-up. Shunt velocities were recorded within the TIPSS at the proximal (hepatic vein segment) and distal part (portal vein segment).
Results:
In 28 patients with functioning TIPSS the mean shunt velocity ranged between 30 and 120 cm/s (median 60 cm/s) at the portal vein segment and between 60 and 155 cm/s (median 82 cm/s) at the hepatic vein segment. There was a significant increase of the mean shunt velocity in the hepatic vein segment (P < 0.001). In 12 patients with compromised TIPSS the mean shunt velocity was reduced to 26 +/- 7 cm/s at the portal venous end (P < 0.0001).
Conclusion:
Because of an accelerated shunt velocity in the hepatic vein segment a site-specific evaluation of both TIPSS endings is necessary with color Doppler sonography. In compromised TIPSS the shunt velocity is reduced at the portal venous end. Color Doppler sonography is a valid non-invasive means for follow-up of patients with TIPSS.