Abstract:

Transjugular intrahepatic portosystemic shunt (TIPS) is a common minimally invasive interventional technique for the treatment of liver cirrhosis patients with esophagus and gastric varices and intractable ascites. At present, portal vein puncture is still the difficulty and bottleneck of the operation. Repeated puncture of portal vein may lead to serious complications or even death during perioperative period. Traditionally, vein puncture is an experiential puncture under fluoroscopy, which is blind to some extent and depends heavily on the experience of the operators. In order to reduce the number of puncture times and optimize the accuracy, a variety of puncture guidance techniques have emerged in clinical practice, including direct portal vein puncture marker, CO₂ portal venography marker, real-time bedside ultrasound guidance, and image fusion assistance. These puncture guidance techniques have their own advantages and disadvantages and are evolving in practice. Among them, the potential of image fusion technology is gradually released, which makes portal vein puncture guidance more intelligent, intuitive and concise, and makes TIPS safer. This paper summarizes the progress of this technique.

Key words: Transjugular intrahepatic portosystemic shunt, Image fusion, Portal vein puncture