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Intraluminal Brachytherapy of De Novo TIPS: A Prospective Randomized Double-Blind Study

Nico Hidajat1,2, Andre Stupavsky1, Johanna Gellermann1, Michael Kreuschner1, Holger Stahl1, Peter Wust1, Roland Felix1 and Ralf-Juergen Schroeder1

1 Department of Radiology, Charité Hospital, Berlin, Germany.
2 Present address: Central Department of Diagnostic and Interventional Radiology, Hospital Peine, Virchowstr. 8 h, Peine 31224, Germany.


Figure 1
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  		Fig. 1 —Drawings show centering PARIS catheter system (Nucletron) used. As a result of balloon segmentation, catheter is centered by inflation of balloon.

 

Figure 2
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  		Fig. 2 —Fluoroscopy image shows centering balloon catheter introduced into transjugular intrahepatic portosystemic shunt. Length of every balloon segment is 1 cm. Lowermost balloon segment (white arrow) is in portal vein about 1 cm from entry of stent into punctured portal vein branch. Sixth balloon segment (black arrow) is in inferior vena cava; thus, irradiation route should have length of 6 cm.

 

Figure 3
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  		Fig. 3A —Line graphs show flow velocities into transjugular intrahepatic portosystemic shunt. Graph shows maximum flow velocity in shunt in irradiation group of 17 patients. Five patients (thick lines) developed shunt stenosis, reducing flow velocity to less than 50 cm/sec during observation time of 1 year.

 

Figure 4
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  		Fig. 3B —Line graphs show flow velocities into transjugular intrahepatic portosystemic shunt. Graph shows maximum flow velocity in shunt in control group of 15 patients. Ten patients (thick lines) developed shunt stenosis, reducing flow velocity to less than 50 cm/sec during observation time of 1 year.

 

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