What imaging method is used during the TIPSS procedure to acquire images?

During the Transjugular Intrahepatic Portosystemic Shunt (TIPSS) procedure, imaging is critical for guiding the intervention and ensuring the accurate placement of the shunt. The use of CO2 or contrast during the procedure allows for real-time visualization of the vascular structures involved.

Specifically, CO2 is often utilized as a contrast agent in patients who may have renal impairment and are at risk for contrast-induced nephropathy. CO2 is less nephrotoxic and can outline the vascular environment without the risks associated with traditional iodinated contrast agents. This technique aids the interventional radiologist in confirming the access points and identifying the anatomy of the hepatic and portal veins for successful shunt placement.

While fluoroscopy and ultrasound are also used in various capacities during TIPSS procedures, the particular emphasis on using CO2 or contrast directly correlates with the requirement to visualize the intervention precisely. CT scans, while providing excellent imaging, are not typically used in real-time during the procedure due to their static nature and longer acquisition time, which does not align with the dynamic requirements of an interventional procedure.

The specific answer highlights the importance of real-time imaging in ensuring the success and safety of the TIPSS intervention.