TIPS

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

Go back to ultrasound protocols homepage