Radiation Exposure in Transjugular Intrahepatic Portosystemic Shunt Creation

Roberto Miraglia, Luigi Maruzzelli, Kelvin Cortis, Mario D’Amico, Gaetano Floridia, Giuseppe Gallo, Corrado Tafaro, Angelo Luca

Research output: Contribution to journalArticlepeer-review


Purpose: Transjugular intrahepatic portosystemic shunt (TIPS) creation is considered as being one of the most complex procedures in abdominal interventional radiology. Our aim was twofold: quantification of TIPS-related patient radiation exposure in our center and identification of factors leading to reduced radiation exposure. Materials and methods: Three hundred and forty seven consecutive patients underwent TIPS in our center between 2007 and 2014. Three main procedure categories were identified: Group I (n = 88)—fluoroscopic-guided portal vein targeting, procedure done in an image intensifier-based angiographic system (IIDS); Group II (n = 48)—ultrasound-guided portal vein puncture, procedure done in an IIDS; and Group III (n = 211)—ultrasound-guided portal vein puncture, procedure done in a flat panel detector-based system (FPDS). Radiation exposure (dose-area product [DAP], in Gy cm2 and fluoroscopy time [FT] in minutes) was retrospectively analyzed. Results: DAP was significantly higher in Group I (mean ± SD 360 ± 298; median 287; 75th percentile 389 Gy cm2) as compared to Group II (217 ± 130; 178; 276 Gy cm2; p = 0.002) and Group III (129 ± 117; 70; 150 Gy cm2

Original languageEnglish
Pages (from-to)210-217
Number of pages8
JournalCardioVascular and Interventional Radiology
Issue number2
Publication statusPublished - Feb 1 2016


  • Fluoroscopy
  • Liver/hepatic
  • Portal vein hypertension
  • Radiation protection
  • Transjugular intrahepatic portosystemic shunt (TIPS/TIPSS)
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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