From the Guidelines
The recommended needle size for a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure is not explicitly stated in terms of needle size, but the procedure typically involves a 10-Fr introducer sheath [ 1 ].
Key Considerations
- The size of the portosystemic shunt is crucial, with larger diameters associated with a greater risk of hepatic encephalopathy (HE), but also more effective in reducing portal pressure [ 1 ].
- A study comparing 8 mm and 10 mm stents found that the smaller diameter stent was associated with less control of complications of portal hypertension [ 1 ].
- The use of controlled expansion stents with a "dial-able" diameter of 8 or 10 mm may allow for modulation of the encephalopathy rate, but this is not evidence-based [ 1 ].
Procedure Details
- The procedure may involve a 10-mm diameter angioplasty balloon for dilation of the intrahepatic shunt, and a 0.035-inch guidewire to facilitate passage of the catheter and introducer sheath through the hepatic and portal veins.
- The Rosch-Uchida transjugular liver access set, which includes a 10-Fr sheath and a 5-Fr catheter, is commonly employed for cannulation of the hepatic vein and portal vein.
From the Research
Needle Size for TIPS Procedure
- The recommended needle size for a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure is not explicitly stated in the provided studies 2, 3.
- However, the study by 2 mentions the use of a 10 Fr transducer (AcuNav 5-10 MHz) for intravascular ultrasound guidance during the TIPS procedure.
- Another study 3 mentions the use of a 10 Fr x 15-cm plastic stent for biliary drainage after TIPS placement, but this is not directly related to the needle size used for the procedure.
- There is no direct evidence in the provided studies to recommend a specific needle size for the TIPS procedure.