Multidetector-Row Computed Tomography in the Evaluation of Transjugular Intrahepatic Portosystemic Shunt Performed with Expanded-Polytetrafluoroethylene-Covered Stent-Graft

Journal Article · Tue Feb 15 00:00:00 EST 2011 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-010-9902-2· OSTI ID:21608817

Fanelli, Fabrizio; Bezzi, Mario; Bruni, Antonio; Corona, Mario; Boatta, Emanuele; Lucatelli, Pierleone; Passariello, Roberto ^[1]

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1. 'Sapienza' University of Rome, Department of Radiologic Sciences, Vascular and Interventional Radiology Unit (Italy)

We assessed, in a prospective study, the efficacy of multidetector spiral computed tomography (MDCT) in the evaluation of transjugular intrahepatic portosystemic shunt (TIPS) patency in patients treated with the Viatorr (Gore, Flagstaff, AZ) expanded-polytetrafluoroethylene (e-PTFE)-covered stent-graft. Eighty patients who underwent TIPS procedure using the Viatorr self-expanding e-PTFE stent-graft were evaluated at follow-up of 1, 3, 6, and 12 months with clinical and laboratory tests as well as ultrasound-color Doppler (USCD) imaging. In case of varices, upper gastrointestinal endoscopy was also performed. In addition, the shunt was evaluated using MDCT at 6 and 12 months. In all cases of abnormal findings and discrepancy between MDCT and USCD, invasive control venography was performed. MDCT images were acquired before and after injection of intravenous contrast media on the axial plane and after three-dimensional reconstruction using different algorithms. MDCT was successfully performed in all patients. No artefacts correlated to the Viatorr stent-graft were observed. A missing correlation between UCSD and MDCT was noticed in 20 of 80 (25%) patients. Invasive control venography confirmed shunt patency in 16 (80%) cases and shunt malfunction in 4 (20%) cases. According to these data, MDCT sensitivity was 95.2%; specificity was 96.6%; and positive (PPV) and negative predictive values (NPV) were 90.9 and 98.2%, respectively. USCD sensitivity was 90%; specificity was 75%; and PPV and NPV were 54.5 and 95.7%, respectively. A high correlation (K value = 0.85) between MDCT and invasive control venography was observed. On the basis of these results, MDCT shows superior sensitivity and specificity compared with USCD in those patients in whom TIPS was performed with the Viatorr stent-graft. MDCT can be considered a valid tool in the follow-up of these patients.

• OSTI ID: 21608817
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 34, Issue 1; Conference: BSIR 2010: Annual meeting of the British Society of Interventional Radiology, Liverpool (United Kingdom), 3-5 Nov 2010; Other Information: DOI: 10.1007/s00270-010-9902-2; Copyright (c) 2011 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
BYPASSES
COMPUTERIZED TOMOGRAPHY
CONTROL
EVALUATION
GRAFTS
IMAGES
PATIENTS
SENSITIVITY
SPECIFICITY
TEFLON
DIAGNOSTIC TECHNIQUES
FLUORINATED ALIPHATIC HYDROCARBONS
HALOGENATED ALIPHATIC HYDROCARBONS
MATERIALS
ORGANIC COMPOUNDS
ORGANIC FLUORINE COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC POLYMERS
PETROCHEMICALS
PETROLEUM PRODUCTS
PLASTICS
POLYETHYLENES
POLYMERS
POLYOLEFINS
POLYTETRAFLUOROETHYLENE
SYNTHETIC MATERIALS
TOMOGRAPHY
TRANSPLANTS