Drug & Device Development

Fluoroscopy plus CT allows real-time evaluation of liver shunt placement

Last Updated: 2007-12-03 10:40:22 -0400 (Reuters Health)

By Martha Kerr

CHICAGO (Reuters Health) - A technique using a liver shunt to treat portal hypertension was first tested just 2 weeks ago and reported here by investigators at the University of Virginia in Charlottesville.

The technique combines two older technologies, fluoroscopy and computed tomography (CT), and also uses a free-moving "C-arm" to allow easy access to the patient from nearly any direction. It has the ability to provide imaging throughout the procedure.

The surgeon involved in the procedure was Dr. John Angle, who described it in an interview with Reuters Health during the ongoing 93rd scientific assembly of the Radiology Society of North America.

Dr. Angle and his colleagues have already used rotational digital acquisition technology to facilitate accurate percutaneous kidney access for successful percutaneous nephrolithotripsy in more than 50 patients.

Dr. Angle found that portions of the stones were in a different calyx than expected on the planar images in 11% of patients, and rotational digital CT provided additional information in fully half of the patients.

"CT provides soft tissue information that has always been available separately, before a procedure is done. Now, we can stop and get these images periodically during the procedure within a matter of minutes," Dr. Angle explained.

On November 14th, the procedure was used for the first time in this country when Dr. Angle placed a hepatic shunt in a patient with portal hypertension to decompress blood vessels.

"I see our field being made safer by fusing these multiple modalities to perform more minimally invasive procedures," Dr. Angle stated. "We could use it during chemoembolism, when we're injecting chemotherapy into the liver vessels in patients with liver cancer, and in a variety of other settings, including angiography and any settings in which fluoroscopy would be used."