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ultrasound protocol to assess tips

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Assess:
  • Portal vein with real-time, PW and colour Doppler for:
    • Size of vessel
    • Presence of thrombus
    • Direction of flow
    • Maximum velocity (Vmax) of flow prior to stent

  • TIPS stent with real-time, PW and colour Doppler for:
  • Vmax in stent (careful assessment of velocities throughout the stent is required
  • Vmax in portal 1/3 of stent
  • Evidence of narrowing of lumen (reduced lumen in real-time or colour, turbulent colour pattern)
  • Hepatic vein with real-time, PW and colour Doppler for:
    • Increase velocity beyond stent
    • Presence of thrombus or narrowing of vein beyond stent

  • IVC with real-time, PW and colour Doppler for:
    • Normal flow patterns
    • Presence of thrombus
Note: visualization of the hepatic vein and IVC may be limited or impossible in a significant number of patients



Standard Documentation:

Essential:
  • Portal vein prior to stent
  • Long axis with lumenal diameter / clip store with colour Doppler
  • Spectral trace with Vmax

TIPS Stent

  • Long axis views low, mid and high / clip store with colour Doppler
  • Spectral trace in portal 1/3 of stent with Vmax measured
  • Spectral trace of the highest velocity found in the stent with Vmax measured
Acquire if possible:

  • Hepatic vein
  • Long axis / clip store with colour Doppler
  • Spectral trace with Vmax
  • IVC
  • Long axis / clip store with colour Doppler
  • Spectral trace with Vmax


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AndyC
AndyC
Latest page update: made by AndyC , Feb 5 2009, 3:32 AM EST (about this update About This Update AndyC Edited by AndyC

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