THE ROLE OF DUPLEX AND COLOR DOPPLER ULTRASOUND IN THE FOLLOW-UP EVALUATION OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC STENT-SHUNT (TIPSS)

Transjugular intrahepatic portosystemic stent shunt (TIPSS) is an effe ctive means of controlling acute variceal haemorrhage. Shunt occlusion or stenosis occurs in up to 30% of patients within 6 months. It is im portant to detect these patients and intervene to prevent rebleeding. We have compared non-invasive Doppler ultrasound with the portal press ure gradient (PPG) at portography at 3 month follow-up in 23 patients. All patients with a shunt peak velocity greater than 90 cm s(-1) (7 o f 17 analysable results) had normal shunt function at portography (PPG <12 mmHg). Portography may therefore be avoided in this group, althou gh the majority of patients will still require portography for TIPSS f ollow-up assessment.