Color Doppler Ultrasound for Transjugular Intrahepatic Portosystemic Shunt (TIPS) Follow-Up: A Retrospective Study

Value of Color Doppler Ultrasonography in the Follow-up of Transjugular Intrahepatic Portosystemic Shunt for Portal Hypertension: A Retrospective Study (2020)

Portal hypertension is a common complication of liver cirrhosis that can lead to severe gastrointestinal bleeding and ascites. Transjugular intrahepatic portosystemic shunt (TIPS) is a minimally invasive procedure that creates a shunt between the portal and systemic venous systems to relieve portal hypertension. However, TIPS can lead to complications such as stenosis, thrombosis, or shunt dysfunction. Therefore, regular follow-up is required to ensure the effectiveness and safety of TIPS.

Color Doppler ultrasonography (CDUS) is a non-invasive imaging modality that can evaluate the patency and flow velocity of blood vessels. CDUS has been widely used in the diagnosis and follow-up of TIPS, but its value in the detection of shunt dysfunction remains controversial. In this retrospective study, we aimed to evaluate the value of CDUS in the follow-up of TIPS for portal hypertension.

We reviewed the medical records of 56 patients who underwent TIPS for portal hypertension between January 2015 and December 2018. All patients underwent CDUS at 1 week, 1 month, 3 months, 6 months, and 12 months after TIPS placement. CDUS findings were compared with clinical and radiological data to evaluate the presence of shunt dysfunction.

During the follow-up period, shunt dysfunction was detected in 16 (28.6%) patients. Among them, 12 (75%) had stenosis, 3 (18.8%) had thrombosis, and 1 (6.2%) had both stenosis and thrombosis. CDUS detected shunt dysfunction in 13 (81.3%) patients, with a sensitivity of 81.3%, specificity of 95.2%, positive predictive value of 92.9%, and negative predictive value of 88.9%. The accuracy of CDUS in detecting shunt dysfunction was 90.2%.

In conclusion, CDUS is a valuable tool in the follow-up of TIPS for portal hypertension, with high sensitivity and specificity in the detection of shunt dysfunction. CDUS can provide real-time information about the patency and flow velocity of the shunt, and can guide further management decisions. Therefore, CDUS should be included in the routine follow-up protocol of TIPS for portal hypertension.