BackTable Vascular & Interventional

Ep. 285 TIPS with ICE Guidance with Dr. Merve Ozen


Listen Later

In this episode, host Dr. Aparna Baheti interviews Dr. Merve Ozen, interventional radiologist, about how to integrate ICE for TIPS, including why she uses a vampire stick, her needle preference, and tips for single operators.


---


CHECK OUT OUR SPONSOR


Medtronic VenaSeal

https://www.medtronic.com/venaseal


---


EARN CME


Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/nfh4bj


---


SHOW NOTES


Dr. Ozen begins by discussing the challenges she faced when introducing this new technique into her practice at the University of Kentucky. She faced pushback from administration about procedure time and anesthesia time. She now does all her TIPS with intracardiac echocardiography (ICE) guidance, but she keeps CO2 available in case of device malfunction, which would cause her to revert to the traditional method of CO2 angiography.


It takes time to learn how to navigate the ICE probe, also called intravascular ultrasound (IVUS), but it helps with complicated cases like thrombosed portal veins and Budd-Chiari syndrome. She uses the “vampire stick” technique, which is a side by side internal jugular access technique for the TIPS needle and the US probe. She puts her TIPS access more medial, which makes it more stable, and places her ICE access more lateral.


After getting access, she spends time understanding the anatomy in the liver. Prior CT is useful for getting information about patient specific anatomy. She then uses ICE to view the portal vein and hepatic vein on the same plane, then she advances the needle with one stick. Dr. Ozen prefers a Rösch-Uchida needle versus a Colapinto because she feels she can better visualize it with ICE. One thing she recommends spending time on is understanding where to start introducing your needle. If there is clot or liver stuck in the needle and preventing blood return, she recommends flushing the needle, or advancing it and then pulling back gently. She ends by stating that learning how to operate the ICE probe is a steep learning curve, but one that every IR should invest time in. It cuts down on anesthesia and fluoroscopy time, and provides a level of safety that is simply not achievable with traditional methods.


---


RESOURCES


ARRS 2022 Abstract on ICE TIPS:

https://apps.arrs.org/AbstractsAM22Open/Main/Abstract/E2038

...more
View all episodesView all episodes
Download on the App Store

BackTable Vascular & InterventionalBy BackTable

  • 4.8
  • 4.8
  • 4.8
  • 4.8
  • 4.8

4.8

133 ratings


More shows like BackTable Vascular & Interventional

View all
Freakonomics Radio by Freakonomics Radio + Stitcher

Freakonomics Radio

32,137 Listeners

Behind The Knife: The Surgery Podcast by Behind The Knife: The Surgery Podcast

Behind The Knife: The Surgery Podcast

1,305 Listeners

Pivot by New York Magazine

Pivot

9,067 Listeners

How I Built This with Guy Raz by Guy Raz | Wondery

How I Built This with Guy Raz

30,253 Listeners

White Coat Investor Podcast by Dr. Jim Dahle of the White Coat Investor

White Coat Investor Podcast

2,422 Listeners

The Daily by The New York Times

The Daily

111,165 Listeners

The Indicator from Planet Money by NPR

The Indicator from Planet Money

9,530 Listeners

The Daily Show: Ears Edition by iHeartPodcasts and Paramount Podcasts

The Daily Show: Ears Edition

14,187 Listeners

Money Meets Medicine by Doctor Podcast Network, Jimmy Turner MD

Money Meets Medicine

217 Listeners

The Passive Income MD Podcast by Peter Kim, MD

The Passive Income MD Podcast

280 Listeners

The Kinked Wire by Society of Interventional Radiology

The Kinked Wire

6 Listeners

The Prof G Pod with Scott Galloway by Vox Media Podcast Network

The Prof G Pod with Scott Galloway

5,284 Listeners

BackTable MSK by BackTable

BackTable MSK

2 Listeners

Prof G Markets by Vox Media Podcast Network

Prof G Markets

977 Listeners

BackTable Tumor Board by BackTable Inc.

BackTable Tumor Board

0 Listeners