Miao Lei, Ren Jing-Lin, Zhao He, Li Xiao
Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Professional Competence, National Health Commission Capacity Building and Continuing Education Center, Beijing 100191, China.
World J Hepatol. 2025 Aug 27;17(8):109496. doi: 10.4254/wjh.v17.i8.109496.
A recent study in examined the use of intravascular ultrasound (IVUS) for transjugular intrahepatic portosystemic shunt (TIPS) creation. The study concluded that IVUS significantly reduces procedure time, radiation exposure, and the number of needle passes compared to conventional fluoroscopic guidance. IVUS offers real-time visualization of the portal vein, but challenges remain in terms of equipment costs and the operator learning curve. TIPS creation techniques vary widely in clinical practice, where methods, such as conventional fluoroscopy, three-dimensional image fusion, electromagnetic navigation, and IVUS, are commonly employed. In this editorial, we provide a comparative analysis of these methods based on clinical experience and the literature. By evaluating the strengths and limitations of each technique, we aim to inform clinical decision-making and enhance procedural outcomes. Future developments in TIPS creation are likely to focus on hybrid techniques that combine the strengths of IVUS, electromagnetic navigation, and real-time image fusion, potentially leading to more precise, cost-effective, and accessible methods.
最近一项研究调查了血管内超声（IVUS）在经颈静脉肝内门体分流术（TIPS）创建中的应用。该研究得出结论，与传统的荧光透视引导相比，IVUS可显著缩短手术时间、减少辐射暴露以及穿刺针的穿刺次数。IVUS可提供门静脉的实时可视化，但在设备成本和操作者学习曲线方面仍存在挑战。TIPS创建技术在临床实践中差异很大，常用的方法包括传统荧光透视、三维图像融合、电磁导航和IVUS等。在这篇社论中，我们根据临床经验和文献对这些方法进行了比较分析。通过评估每种技术的优缺点，我们旨在为临床决策提供参考并改善手术效果。TIPS创建的未来发展可能会集中在结合IVUS、电磁导航和实时图像融合优势的混合技术上，这可能会带来更精确、更具成本效益且更易操作的方法。
