Duplex Ultrasound Versus Clinical Surveillance in the Prediction of TIPS Malfunction Placed for Refractory Ascites: Is Ultrasound Surveillance Useful?

Shamar J Young, Patrick Scanlon, Prashant Sherestha, Jafar Golzarian, Tina S Sanghvi

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Purpose: Since the advent of expanded polytetrafluoroethylene-covered stents and the improved patency they confer for transjugular intrahepatic portosystemic shunt (TIPS), the need to perform ultrasound surveillance has been debated. Prior reports have failed to separately evaluate patients who had TIPS placed for refractory ascites and variceal bleeding. The difference in morbidity from TIPS malfunction between these cohorts argues for distinction between the two. This retrospective review aims to determine whether Duplex ultrasound or return of symptoms more accurately predicts TIPS dysfunction. Materials and Methods: Seventy-eight consecutive venograms in forty patients were retrospectively reviewed. TIPS venograms were used as the gold standard for TIPS dysfunction and considered abnormal if a pressure gradient >12 mmHg was discovered. Patients’ charts were reviewed to assess for a return/worsening of ascites. Lastly, the two ultrasounds prior to TIPS revision were evaluated. Results: The sensitivities of symptom relapse and ultrasound were 83 and 80.0%, respectively, while the specificities were 38.7 and 4.0%, respectively. The sensitivities were not found to be statistically different (p > 0.05); however, symptom relapse was found to be statistically more specific (p < 0.05). Conclusion: Symptom relapse is as sensitive and perhaps more specific than ultrasound in patients who had TIPS placed for refractory ascites.

Original languageEnglish (US)
Pages (from-to)1861-1865
Number of pages5
JournalCardioVascular and Interventional Radiology
Volume40
Issue number12
DOIs
StatePublished - Dec 1 2017

Keywords

  • Surveillance
  • Transjugular intrahepatic portosystemic shunt
  • Ultrasound

PubMed: MeSH publication types

  • Comparative Study
  • Journal Article

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