Portal vein velocities measured by ultrasound: usefulness for evaluating shunt functioning following TIPS placement and TIPS revision.

BACKGROUND

To assess the usefulness of following portal vein velocities by Doppler ultrasound in evaluating shunt functioning after transhepatic intrajugular portosystemic shunt (TIPS) placement and revision.

METHODS

We retrospectively analyzed 39 patients who underwent a TIPS procedure in the preceding 4 years. Portal vein (PV) velocities were measured by Doppler ultrasound before and after TIPS insertion and revision and were correlated with portosystemic gradients (PSG) measured at angiography.

RESULTS

Mean PV velocities increased from 18 +/- 6 cm/s before TIPS placement to 50 +/- 21 cm/s (p < 0.001) after TIPS placement, with corresponding decrease of mean PSG from 20 +/- 6 to 8 +/- 3 mmHg (p < 0.001). Mean PV velocities significantly increased from 24 +/- 6 to 43 +/- 14 cm/s after TIPS revision (p < 0.02), with decrease of PSG from 17 +/- 6 to 9 +/- 5 mmHg (p < 0.05). A significant correlation was found between all PV velocities and their corresponding PSG (Spearman r < 0.61, p < 0.001).

CONCLUSION

PV velocities significantly correlate with changes in PSG. Following portal vein velocities by ultrasound is useful for early evaluation of shunt functioning following TIPS.