Transjugular intrahepatic portosystemic shunt (TIPS) is a complex intervention with
a steep learning curve that requires centers of expertise to improve technical success
and reduce complications. Portal venous access is the most challenging step of the
procedure and requires planning and image guidance strategies to prevent vascular
or bile duct injury and further complications. Intracardiac echocardiography (ICE)
has been reported to be a safe and accurate tool that provides images of the portal
vein anatomy in real time. The use of ICE has become the standard of care in several
centers. It is now frequently used to target the portal vein in complex TIPS procedures.
This review article describes some technical aspects and indications of ICE-guided
TIPS.
Keywords
transjugular intrahepatic portosystemic shunt - intracardiac echocardiography - portal
vein - hepatic vein - interventional radiology