How do you size your stent and can you describe stent deployment?

Referrals & Pre-TIPS Workup with Dr. Emmett Lynskey

Lesson 1

Tell us about how your referral pattern for TIPS has evolved

Lesson 2

How do you work with hepatologists to workup TIPS patients?

Lesson 3

What are the most common indications for TIPS and what do you see most commonly in your practice?

Lesson 4

Can you explain MELD score on a basic level and what value within MELD is a driver for what you do?

Lesson 5

What is the cutoff MELD score for patients you won't take for TIPS?

Lesson 6

How does the backup of a transplant let you be flexible on your MELD score criteria if the patient has refractory ascites?

Lesson 7

How does the cross sectional help you with TIPS planning?

Lesson 8

Are there any times when you consider alternatives to TIPS?

Lesson 9

Can you talk about the considerations you have the day of the procedure?

Lesson 10

Can you talk about why you want to have the paracentesis the day of?

Basic TIPS Procedure Technique with Dr. Emmett Lynskey

Lesson 11

Can you take us through the beginning steps of how a TIPS is performed?

Lesson 12

What is the next step after you have access and have taken your pressures?

Lesson 13

Can you talk about the different TIPS sets?

Lesson 14

Talk about the needle pass and finding the right access site

Lesson 15

How do you get your wire and sheath through into the portal system?

Lesson 16

Tell us about the portogram and what are you trying to see while doing the dual run?

Lesson 17

How do you size your stent and can you describe stent deployment?

Lesson 18

Can you discuss the gradients and what your goals are?

Lesson 19

Can you talk about embolization after deployment of the TIPS?

Lesson 20

What is your follow up and post procedural care protocol?

Lesson 21

How important is it to counsel the patient’s care-taker or spouse?

Using ICE & Splenic Access for TIPS with Dr. Emmett Lynskey

Lesson 22

When did intracardiac echo (ICE) first get on your radar and how did you overcome the learning curve?

Lesson 23

Tell us how you are using ICE for TIPS

Lesson 24

Do you need someone else to manipulate the probe for you or are you able to park the probe as you go?

Lesson 25

Describe how you make throws using the ICE probe and select the section of the hepatic vein you want to enter

Lesson 26

How many times did you use the ICE catheter before it became something essential?

Lesson 27

Is ICE helpful in a chronic thrombosis situation and TIPS revisions?

Lesson 28

Are there other situations where the ICE catheter is useful?

Lesson 29

Can you talk about the ABC's of splenic access and also the technical maneuvers that make it easier?

Lesson 30

Can you describe the tactile feel to accessing a splenic vein?

Lesson 31

What wires and sheaths are you using for splenic access?

Lesson 32

What are your steps in terms of accessing the native portal vein or the thrombosed section of the portal vein?