Feasibility of electromagnetically guided transjugular intrahepatic portosystemic shunt procedure

Peter Isfort, Tobias Penzkofer, Christoph Wilkmann, Hong Sik Na, Christian Kotzlowski, Nobutake Ito, Joachim Georg Pfeffer, Stefan Bisplinghoff, Sabine Osterhues, Andreas Besting, Jorge Gooding, Thomas Schmitz-Rode, Christiane Kuhl, Andreas Horst Mahnken, Philipp Bruners

Research output: Contribution to journalArticle

Abstract

Objectives: To develop an electromagnetic navigation technology for transjugular intrahepatic portosystemic shunt (TIPS) creation and translate it from phantom to an in-vivo large animal setting. Material and methods: A custom-designed device for TIPS creation consisting of a stylet within a 5 French catheter as well as a software prototype were developed that allow real-time tip tracking of both stylet and catheter using an electromagnetic tracking system. Feasibility of navigated TIPSS creation was tested in a phantom by two interventional radiologists (A/B) followed by in-vivo testing evaluation in eight domestic pigs. Procedure duration and number of attempts needed for puncture of the portal vein were recorded. Results: In the phantom setting, intervention time to gain access to the portal vein (PV) was 144 ± 67 s (A) and 122 ± 51 s (B), respectively. In the in-vivo trials, TIPS could be successfully completed in five out of eight animals. Mean time for the complete TIPS was 245 ± 205 minutes with a notable learning curve towards the last animal. Conclusions: TIPS creation with the use of electromagnetic tracking technology proved to be feasible in-vitro as well as in-vivo. The system may be useful to facilitate challenging TIPSS procedures.

Original languageEnglish
Pages (from-to)15-22
Number of pages8
JournalMinimally Invasive Therapy and Allied Technologies
Volume26
Issue number1
DOIs
Publication statusPublished - 2017 Jan 2

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Keywords

  • Image-guided procedures
  • interventional radiology
  • vascular intervention

ASJC Scopus subject areas

  • Surgery

Cite this

Isfort, P., Penzkofer, T., Wilkmann, C., Na, H. S., Kotzlowski, C., Ito, N., Pfeffer, J. G., Bisplinghoff, S., Osterhues, S., Besting, A., Gooding, J., Schmitz-Rode, T., Kuhl, C., Mahnken, A. H., & Bruners, P. (2017). Feasibility of electromagnetically guided transjugular intrahepatic portosystemic shunt procedure. Minimally Invasive Therapy and Allied Technologies, 26(1), 15-22. https://doi.org/10.1080/13645706.2016.1214155