Safety and Feasibility of Gun-Sight Technique for Transjugular Intra-hepatic Portosystemic Shunt (TIPS) Creation. 

 -  2023 
<br/><br/> CONCLUSION: Gun-sight technique for TIPS creation has a high success rate in this challenging cohort of patients. While complications can occur, most of the adverse events noted were likely associated with TIPS creation itself rather than gun-sight. Early thrombosis only occurred in patients with PVT. Level of Evidence Level 4, Case Series. Copyright © 2023. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).  MATERIALS AND METHODS: A multicenter retrospective review was performed. Forty-two TIPS procedures with gun-sight technique were identified between 2016 and 2021. Eighty-six percent of patients had portal vein thrombosis (PVT), and 21% had undergone prior failed TIPS creation. Demographics, procedure details and outcomes were reviewed. Differences between the groups, event rates and patency rates were evaluated using nonparametric two-sample Wilcoxon rank-sum (Mann-Whitney) test, Fisher's exact test, Kaplan-Meier curves, and log-rank test.  PURPOSE: To review technical details, indications for use, success rates and complications of gun-sight technique for transjugular intra-hepatic portosystemic shunt (TIPS) creation.  RESULTS: Technical success was 98%. Sixty-seven percent of subjects had transsplenic and 26% had transhepatic access for TIPS creation. Twenty-one adverse events were noted (48%), four of which were definitely related and four were probably related to the use of gun-sight technique. Early (within 90 days) thrombosis occurred in 7/41 patients (17%), all of whom had existing PVT. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0174-1551 
<br/><br/><label>Standard No.: </label>10.1007/s00270-023-03528-5 [doi] 10.1007/s00270-023-03528-5 [pii] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Portasystemic Shunt, Transjugular Intrahepatic<br/>*Thrombosis<br/>*Venous Thrombosis<br/>Feasibility Studies<br/>Humans<br/>Portal Vein/su [Surgery]<br/>Portasystemic Shunt, Transjugular Intrahepatic/mt [Methods]<br/>Retrospective Studies<br/>Thrombosis/co [Complications]<br/>Treatment Outcome<br/>Venous Thrombosis/et [Etiology]--Automated
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Occupation: </label><br/>MedStar Georgetown University Hospital/MedStar Washington Hospital Center<br/>Radiology<br/>Radiology/Interventional Integrated Residency Sunhye<br/>Radiology/Interventional Radiology Independent Fellowshipdo Jake
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article<br/>Multicenter Study