The electromagnetic navigation ultrasonography guidance for portal vein access during transjugular intrahepatic portosystemic shunt  creation

Purpose This study aims to assess the feasibility and safety of utilizing electromagnetic navigation ultrasonography (ENU) guidance during transjugular intrahepatic portosystemic shunt (TIPS) creation. Methods Portal vein (PV) puncture during TIPS procedures was facilitated using an ENU system device. Key procedural metrics recorded for each case included the number of needle passes, fluoroscopy time, total procedure duration, dose area product (DAP), air kerma (AK), and incidence of procedural complications. Results The study included six patients (five men and one woman) with a mean age of 50.6 ± 13.4 years (range, 33–72 years). With ENU guidance, the mean number of needle passes for successful PV entry was 1.7 ± 0.7 (range, 1 to 3 passes). The average fluoroscopy time for the entire TIPS procedure was 15.3 ± 2.7 minutes (range, 11–19 minutes), and the mean total procedure duration was 91.7 ± 7.8 minutes. The mean DAP associated with the procedure was 143 ± 38.5 Gy · cm2 (range, 89–196 Gy · cm2), with a median AK of 707.7 ± 212.8 mGy (range, 367–1008 mGy). Notably, no clinically significant puncture-related complications were observed. Conclusion Electromagnetic navigation ultrasonography (ENU) guidance demonstrates potential feasibility, safety, and effectiveness in assisting with TIPS procedures.