Miao L, Ren JL, Zhao H, Li X. Optimal guiding methods for transjugular intrahepatic portosystemic shunt creation: Characteristics of intravascular ultrasound vs other techniques. World J Hepatol 2025; 17(8): 109496 [DOI: 10.4254/wjh.v17.i8.109496]
Corresponding Author of This Article
He Zhao, MD, Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. hezhaoo@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Aug 27, 2025; 17(8): 109496 Published online Aug 27, 2025. doi: 10.4254/wjh.v17.i8.109496
Optimal guiding methods for transjugular intrahepatic portosystemic shunt creation: Characteristics of intravascular ultrasound vs other techniques
Lei Miao, Jing-Lin Ren, He Zhao, Xiao Li
Lei Miao, He Zhao, Xiao Li, Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Jing-Lin Ren, Department of Professional Competence, National Health Commission Capacity Building and Continuing Education Center, Beijing 100191, China
Co-corresponding authors: He Zhao and Xiao Li.
Author contributions: Miao L analyzed the data and wrote the manuscript; Zhao H and Li X have played important and indispensable roles in the manuscript preparation as the co-corresponding authors; Miao L, Ren JL, Zhao H, and Li X designed the study; all authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 82330061; The PUMC Graduate Curriculum Informatization Development Special Fund Project, No. 2024YXX004; and The CAMS Initiative for Innovative Medicine, No. 2021-I2M-1-015.
Conflict-of-interest statement: The authors of this manuscript declare that they have no competing interests.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: He Zhao, MD, Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China. hezhaoo@gmail.com
Received: May 14, 2025 Revised: June 17, 2025 Accepted: July 25, 2025 Published online: August 27, 2025 Processing time: 106 Days and 8.3 Hours
Abstract
A recent study in World Journal of Hepatology examined the use of intravascular ultrasound (IVUS) for transjugular intrahepatic portosystemic shunt (TIPS) creation. The study concluded that IVUS significantly reduces procedure time, radiation exposure, and the number of needle passes compared to conventional fluoroscopic guidance. IVUS offers real-time visualization of the portal vein, but challenges remain in terms of equipment costs and the operator learning curve. TIPS creation techniques vary widely in clinical practice, where methods, such as conventional fluoroscopy, three-dimensional image fusion, electromagnetic navigation, and IVUS, are commonly employed. In this editorial, we provide a comparative analysis of these methods based on clinical experience and the literature. By evaluating the strengths and limitations of each technique, we aim to inform clinical decision-making and enhance procedural outcomes. Future developments in TIPS creation are likely to focus on hybrid techniques that combine the strengths of IVUS, electromagnetic navigation, and real-time image fusion, potentially leading to more precise, cost-effective, and accessible methods.
Core Tip: This study compares intravascular ultrasound (IVUS) with conventional techniques for transjugular intrahepatic portosystemic shunt (TIPS) creation. IVUS reduces procedure time, radiation exposure, and needle passes while enhancing precision. Despite higher initial costs, IVUS offers long-term savings through faster procedures and reduced complications. Emerging technologies, such as artificial intelligence integration and miniaturized devices, promise to further improve IVUS-guided TIPS, making it a potentially cost-effective and universally applicable method in the future.
