Poster électronique

TIPS : comment améliorer le repérage du tronc porte
JM. Caporossi, C. Muller, DA. Varoquaux, V. Vidal, G. Moulin, JM. Bartoli - Marseille - France
Congrès 2011
Résumé
Objectifs
Le but de l’étude est d’évaluer la technique de portographie rétrograde iodée en utilisant un ballon d’occlusion dans la veine sushépatique droite. En comparaison avec la technique classique de portographie rétrograde iodée avec cathéter "bloqué" en distalité. Secondairement le but est de diminuer le risque de ponction aberrante pendant la création du TIPS.
Matériels et méthodes
Pendant une période de 2 ans, 57 TIPS ont été réalisés, 30 avec portographie rétrograde en cathéter bloquée, et 27 portographies rétrogrades avec ballon d’occlusion dans la veine sushépatique droite. On utilise un produit de contraste iodé avec injection manuelle. Les résultats sont comparés à la portographie directe après cathéterisme du tronc porte. On definit un score en fonction du degré d’opacification du tronc porte. La procédure est définie comme réussie en cas de visualisation de la bifurcation portale. Les complications sont également évaluées.
Résultats
Dans le premier groupe avec portographie rétrograde bloquée, nous retrouvons 3 ruptures capsulaires avec hémorragie intrapéritonéale dont un décès. Pas de complications dans le groupe avec ballon d’occlusion. La bifurcation portale est visualisée 7/30(23°/o) dans le premier groupe et 15/27(55°/o) dans le second.
Conclusion
Le repérage du tronc porte pendant les TIPS peut être réalisé de manière sûre et efficace et reproductible en réalisant une opacification portale rétrograde avec ballon d’occlusion gonfléà basse pression dans la veine sushépatique droite.
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2017-12-11 04.15 :
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