Transjugular intrahepatic portosystemic shunt creation using intravascular ultrasound vs fluoroscopic guidance: A dual-institution retrospective comparative study

Table 1 Baseline clinical characteristics, n (%)

Variables	cTIPS (n = 135)	iTIPS (n = 66)	P value
Age (years), mean ± SD	58 ± 11	56 ± 10	0.39
Sex (male)	77 (57)	41 (62)	0.54
Ethnicity	-	-	< 0.0001
Non-Hispanic White	113 (84)	37 (56)	-
Hispanic/Latino	7 (5)	25 (38)	-
African American	7 (5)	0 (0)	-
Asian	8 (6)	4 (6)	-
TIPS indication	-	-	0.87
Variceal bleeding	33 (24)	19 (29)	-
Refractory ascites	81 (60)	38 (58)	-
Hepatic hydrothorax	12 (9)	6 (9)	-
Other	9 (7)	3 (4)	-
MELD-Na, mean ± SD	17 ± 14	16 ± 5	0.25
Etiology of liver disease	-	-	0.003
HBV/HCV	26 (19)	26 (39)	-
Alcohol	38 (28)	22 (33)	-
NASH	36 (27)	10 (15)	-
Other	35 (26)	8 (12)	-
PSG Pre-TIPS (mmHg), mean ± SD	18 ± 6	18 ± 4	0.29
PSG Post-TIPS (mmHg), mean ± SD	7 ± 3	6 ± 2	0.13
Final stent diameter (mm)	-	-	0.004
6	1 (1)	2 (3)	-
7	0 (0)	2 (3)	-
8	83 (61)	51 (77)	-
9	6 (4)	3 (5)	-
10	40 (30)	8 (12)	-
Not documented	5 (4)	0 (0)	-

cTIPS: Conventional fluoroscopic-guided transjugular intrahepatic portosystemic shunt; iTIPS: Intravascular ultrasound-guided transjugular intrahepatic portosystemic shunt; TIPS: Transjugular intrahepatic portosystemic shunt; MELD-Na: Model for end-stage liver disease (including serum sodium); HBV: Hepatitis B virus; HCV: Hepatitis C virus; NASH: Non-alcoholic steatohepatitis; PSG: Portosystemic gradient.

Table 2 Post-procedure laboratory marker adverse events at one month, n (%)

Laboratory marker CTCAE grade1	cTIPS	iTIPS	P value
AST2	n = 109	n = 52	0.08
0	74 (68)	44 (85)	-
1	33 (30)	8 (15)	-
2	1 (1)	0 (0)	-
3	0 (0)	0 (0)	-
4	1 (1)	0 (0)	-
ALT3	n = 109	n = 53	0.18
0	102 (94)	53 (100)	-
1	6 (5)	0 (0)	-
2	0 (0)	0 (0)	-
3	1 (1)	0 (0)	-
4	0 (0)	0 (0)	-
Total bilirubin4	n = 109	n = 53	0.82
0	37 (34)	19 (36)	-
1	37 (34)	14 (26)	-
2	24 (22)	14 (26)	-
3	10 (9)	5 (9)	-
4	1 (1)	1 (2)	-
INR	n = 109	n = 53	1
< 2 × BL	109 (100)	53 (100)	-
> 2 × BL	0 (0)	0 (0)	-

¹Uses upper limit of normal if baseline is normal, or baseline if baseline is abnormal.

²The upper limit of normal was 41.

³The upper limit of normal was 63 in men and 54 in women.

⁴The upper limit of normal was 1.2.

P values were obtained using Fisher exact test. cTIPS: Conventional fluoroscopic-guided transjugular intrahepatic portosystemic shunt; iTIPS: Intravascular ultrasound-guided transjugular intrahepatic portosystemic shunt; CTCAE: Common Terminology Criteria for Adverse Events; AST: Aspartate transaminase; ALT: Alanine transaminase; UNL: Upper limit of normal; BL: Baseline; INR: International normalized ratio.