MR-guided transjugular portosystemic shunt placement in a swine model

Stephen T. Kee, John S. Rhee, Kim Butts, Bruce Daniel, John Pauly, Adam Kerr, Gerard J. O'Sullivan, Daniel Y. Sze, Mahmood K. Razavi, Charles P. Semba, Robert J. Herfkens, Michael D. Dake

Research output: Contribution to journalArticle

52 Scopus citations

Abstract

PURPOSE: To evaluate the performance of portal venous puncture with use of magnetic resonance (MR) guidance, and to place a transjugular intrahepatic portosystemic shunt (TIPS) in a swine model. MATERIALS AND METHODS: A study of 12 swine was performed to evaluate the ability of interventional MR imaging to guide portal vein puncture and TIPS placement. Six swine had catheters placed in the right hepatic vein under C-arm fluoroscopy. A nitinol guide wire was left in the vein and the animals were then moved into an open configuration MR imaging unit. A TIPS needle set was used to puncture the portal vein using MR fluoroscopy. The animals were transferred to the C-arm, and venography confirmed portal vein puncture. A follow-up study was performed in six additional swine to place a TIPS using only MR imaging guidance. MR tracking was used to advance a catheter from the right atrium into the inferior vena cava. Puncture of the portal vein was performed and a nitinol stent was placed, bridging the hepatic parenchyma. MR venogram confirmed placement. RESULTS: Successful portal vein puncture was achieved in all animals. The number of punctures required decreased from 12 in the first animal to a single puncture in the last eight swine. A stent was successfully placed across the hepatic tract in all six swine. CONCLUSIONS: Real-time MR imaging proved to be a feasible method to guide portal vein puncture and TIPS placement in pigs.

Original languageEnglish (US)
Pages (from-to)529-535
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume10
Issue number5
DOIs
StatePublished - May 1999
Externally publishedYes

Keywords

  • Magnetic resonance (MR) fluoroscopy
  • Shunts, portosystemic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Kee, S. T., Rhee, J. S., Butts, K., Daniel, B., Pauly, J., Kerr, A., O'Sullivan, G. J., Sze, D. Y., Razavi, M. K., Semba, C. P., Herfkens, R. J., & Dake, M. D. (1999). MR-guided transjugular portosystemic shunt placement in a swine model. Journal of Vascular and Interventional Radiology, 10(5), 529-535. https://doi.org/10.1016/S1051-0443(99)70078-3