FOLLOW-UP OF PATIENTS WITH TIPSS - COMPAR ISON OF COLOR DOPPLER SONOGRAPHY AND VENOUS PORTOGRAPHY

Purpose: Comparison of color Doppler sonography and venous portography in patients with a transjugular intrahepatic portosystemic stents hun t(TIPSS). Materials and methods: In a prospective study 40 consecutive patients with TIPSS underwent venous portography and color Doppler so nography on the same day as follow-up. Shunt velocities were recorded with in the TIPSS at the proximal (hepatic vein segment) and distal pa rt (portal vein segment). Results: In 28 patients with functioning TIP SS the mean shunt velocity ranged between 30 and 120 cm/s (median 60 c m/s) at the portal vein segment and between 60 and 155 cm/s (median 82 cm/s) at the hepatic Vein segment. There was a significant increase o f the mean shunt velocity in the hepatic Vein segment (P<0.001). In 12 patients with compromised TIPSS the mean shunt velocity was reduced t o 26+/-7 cm/s at the portal Venous end (P<0.0001). Conclusion: Because of an accelerated shunt velocity in the hepatic vein segment a site-s pecific evaluation of both TIPSS endings is necessary with color Doppl er sonography. In compromised TI PSS the shunt velocity is reduced at the portal venous end. Color Doppler sonography is a valid non-invasiv e means for follow-up of patients with TIPSS.