Abstract No. 282 Doppler Velocities in Patent Transjugular Portosystemic Shunts: An Analysis of 10-mm versus 8-mm Shunts

To determine if ultrasound Doppler velocities within transjugular portosystemic shunts/direct intrahepatic portosystemic shunts (TIPS/DIPS) differ based on the stent diameter (8 mm vs. 10 mm) and report typical flow velocities at defined locations along the stent in patients with a patent TIPS/DIPS on venography. This study retrospectively analyzed a cohort of TIPS/DIPS recipients at a large tertiary care hospital from 2017 to 2022 (Table 282.1). Sixty-nine patient-entries with patent TIPS/DIPS venograms and available intervening Doppler US were identified (8 mm n=41; men: 70.7%, mean age: 57.5 years [range: 36-75 years]; 10-mm n=28; men: 50%, mean age: 50.2 years [range: 24-74 years]). The mean Doppler velocities were significantly different at the mid-stent (184.7 cm/s in 8-mm stents and 148.9 cm/s in 10-mm stents; p = 0.03, 95% CI 4.1-67.5) and hepatic-venous-end of the TIPS/DIPS (172.4 cm/s in 8-mm stents and 141.3 cm/s in 10-mm stents; p = 0.02, 95% CI 5.2-57.0). The mean Doppler velocities were not significantly different at the main-portal-vein-end (46.8 cm/s in 8 mm stents and 53.0 cm/s in 10-mm stents; p = 0.29, 95% CI -5.4-17.9). Peak velocities occurred at the mid-TIPS location for the majority of patent 8 mm TIPS (n=22) and at the portal-end of TIPS for the majority of 10-mm TIPS (n=12). Normal Doppler velocities within TIPS/DIPS differ depending on the shunt diameter. These findings demonstrate a need for specific Doppler screening thresholds in assessing TIPS/DIPS stents of differing calibers.