From the Guidelines
The recommended needle size for a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure is typically a 16-gauge to 18-gauge needle, but the exact size may vary depending on the specific equipment and patient anatomy. To perform the procedure:
- Insert the needle through the jugular vein access sheath.
- Advance it through the liver parenchyma to access the portal vein.
- Once portal access is achieved, exchange the needle for a guidewire and then the TIPS stent. The optimal needle size is crucial because:
- It provides sufficient stiffness to navigate through liver tissue.
- It allows for adequate flow for contrast injection and pressure measurements.
- It's large enough to accommodate a guidewire for subsequent stent placement. Proper needle selection is crucial for successful portal vein access while minimizing the risk of complications such as bleeding or inadvertent puncture of other structures, as noted in the French guidelines on TIPS 1. However, it's essential to note that the provided evidence does not explicitly mention the needle size for the TIPS procedure, but it discusses the importance of equipment selection and technical challenges in children, highlighting the need for a multidisciplinary discussion to choose the appropriate equipment and approach for each patient 1. Additionally, the North American practice-based recommendations for TIPS in portal hypertension discuss the consideration of TIPS stent diameter to limit post-TIPS hepatic encephalopathy (HE), but do not provide information on needle size 1. Always confirm the specific equipment preferences with your interventional radiology team, as slight variations may exist between institutions.
From the Research
Needle Size for TIPS Procedure
There are no research papers to assist in answering this question, as the provided studies do not mention the Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure.
- The studies provided discuss various medical procedures, including wound flushing 2, liver core-needle biopsy 3, thread trigger digit release 4, ultrasound-guided biopsy for peripheral pulmonary lesions 5, and anesthesia through an intraosseous line 6.
- None of these studies mention the TIPS procedure or the needle size used for it.