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Transjugular intrahepatic portosystemic shunt (TIPS) creation is an established minimally invasive treatment for complications of portal hypertension such as refractory ascites and variceal bleeding. A technically challenging step of the procedure is the puncture of the portal vein from the hepatic vein, which is usually performed under fluoroscopic guidance and may require multiple puncture attempts.
This prospective pilot study evaluates the use of fiber-optic navigation technology during TIPS creation. The system allows real-time three-dimensional visualization of guidewires and catheters and may improve spatial orientation during the procedure.
Approximately 30 patients with a clinical indication for TIPS placement will be included. The study will assess procedural parameters such as the number of puncture attempts, fluoroscopy time, radiation exposure, procedure duration, technical success, and complications.
The results may help to improve procedural efficiency and radiation safety during TIPS interventions.
Transjugular intrahepatic portosystemic shunt (TIPS) creation is an established minimally invasive treatment for complications of portal hypertension, including refractory ascites and variceal bleeding. The most technically demanding step of the procedure is the puncture of the portal vein from the hepatic vein through the liver parenchyma. This step is traditionally performed under fluoroscopic guidance and may require multiple puncture attempts, potentially leading to prolonged procedure times and increased radiation exposure.
Recent technological developments allow real-time three-dimensional visualization of guidewires and catheters using fiber-optic shape sensing technology. This approach may improve spatial orientation during complex endovascular procedures and facilitate more precise navigation within vascular structures.
The present prospective single-center pilot study aims to evaluate the feasibility and procedural impact of fiber-optic navigation during TIPS creation in routine clinical practice. Approximately 30 patients with an established clinical indication for TIPS placement will be included. Procedural parameters including number of puncture attempts, fluoroscopy time, radiation exposure (dose area product), total procedure time, technical success, and procedure-related complications will be prospectively recorded.
The results of this study are expected to provide initial clinical data on the integration of fiber-optic navigation into TIPS procedures and its potential impact on procedural efficiency and radiation safety.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fiber-Optic Navigation-Assisted TIPS | Experimental | Patients undergo transjugular intrahepatic portosystemic shunt (TIPS) creation using fiber-optic navigation technology to assist catheter and guidewire navigation. The procedure is performed according to routine clinical practice at a tertiary interventional radiology center. Procedural parameters including number of puncture attempts, fluoroscopy time, radiation exposure, total procedure time, technical success, and procedure-related complications are prospectively recorded. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fiber-Optic Navigation System | Device | Use of a fiber-optic shape sensing navigation system to assist catheter and guidewire navigation during transjugular intrahepatic portosystemic shunt (TIPS) creation. The system provides real-time three-dimensional visualization of endovascular devices and is used to support portal vein access during the procedure performed according to routine clinical practice. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of puncture attempts required to access the portal vein | Number of needle passes required to successfully puncture the portal vein during TIPS creation. | During the TIPS procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Fluoroscopy Time | Total fluoroscopy time recorded during the TIPS procedure. | During the procedure |
| Radiation Exposure | Radiation exposure measured as dose area product (DAP) during the procedure. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Malik Galijasevic, MD, PhD | Contact | +4351250483248 | malik.galijasevic@i-med.ac.at |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical University of Innsbruck | Innsbruck | Tyrol | 6020 | Austria |
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| ID | Term |
|---|---|
| D008103 | Liver Cirrhosis |
| D001201 | Ascites |
| D006975 | Hypertension, Portal |
| ID | Term |
|---|---|
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D005355 | Fibrosis |
| D010335 | Pathologic Processes |
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This is a prospective single-center pilot study evaluating fiber-optic navigation during transjugular intrahepatic portosystemic shunt (TIPS) creation. All enrolled patients undergo TIPS placement according to routine clinical practice. Procedural parameters including number of puncture attempts, fluoroscopy time, radiation exposure, total procedure time, technical success, and complications are prospectively recorded and analyzed.
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|
| During the procedure |
| Total Procedure Time | Total duration of the TIPS procedure measured from vascular access to completion of the intervention. | During the procedure |
| Technical Success | Successful placement of a transjugular intrahepatic portosystemic shunt with confirmed portal-systemic flow. | End of procedure |
| Procedure-Related Complications | Occurrence of intra-procedural or early post-procedural complications. | Within 30 days after the procedure |
| D013568 |
| Pathological Conditions, Signs and Symptoms |