E1188. ICE IT! How to Implement Intracardiac Echocardiography Into an Interventional Radiology Practice
  1. Neginder Saini; North Shore University Hospital
  2. Ravdeep Oberoi; Touro College of Osteopathic Medicine
  3. Jonathan Weinstein; North Shore University Hospital
  4. Craig Greben; North Shore University Hospital
Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for treating portal hypertension and can prevent life-threating esophageal bleeding. The procedure involves placing a stent between the hepatic and portal vein.

Educational Goals / Teaching Points
By the end of this exhibit, the participant should be able to explain the risks and benefits of transjugular intrahepatic portosystemic shunt (TIPS) creation, provide information on how intracardiac echocardiography (ICE) can be used during TIPS, review utility of ICE during different parts of a TIPS procedure beyond than just portal vein puncture, review the literature regarding the benefits of ICE during TIPS, and explain the equipment, logistics, and potential capital investment needed to start an ICE TIPS program.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The ICE probe is placed through either the internal jugular vein or femoral vein into the intrahepatic inferior vena cava (IVC) and used to evaluate anatomy, assist in puncture of the portal vein, and for stent placement. The number of needle punctures, overall procedure time, radiation dose, and iatrogenic parenchymal injury can be decreased with adjunct use of ICE.

Implementing ICE into a portal hypertension practice is feasible and can improve patient outcomes.