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Feb 5 2009, 9:32 AM EST (current) AndyC 219 words deleted
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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


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 VmaxGo back to ultrasound protocols homepage