top of page

BackTable / VI / Podcast / Episode #285

TIPS with ICE Guidance

with Dr. Merve Ozen

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.

Sponsored by:

Medtronic VenaSeal
TIPS with ICE Guidance with Dr. Merve Ozen on the BackTable VI Podcast)
Ep 285 TIPS with ICE Guidance with Dr. Merve Ozen
00:00 / 01:04

BackTable, LLC (Producer). (2023, January 23). Ep. 285 – TIPS with ICE Guidance [Audio podcast]. Retrieved from

BackTable CMEfy button

Stay Up To Date



Sign Up:

Podcast Contributors

Dr. Merve Ozen discusses TIPS with ICE Guidance on the BackTable 285 Podcast

Dr. Merve Ozen

Dr. Merve Ozen is a practicing interventional radiologist with University of Kentucky Healthcare.

Dr. Aparna Baheti discusses TIPS with ICE Guidance on the BackTable 285 Podcast

Dr. Aparna Baheti

Dr. Aparna Baheti is a practicing Interventional Radiologist in Tacoma, Washington.

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.


Disclaimer: The Materials available on are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

Earn CME When You Listen to BackTable CMEfy

Up Next

Emerging Techniques of Advanced Ultrasound in No Options CLTI Patients with Dr. Miguel Montero-Baker on the BackTable VI Podcast)
Ultrasound Series: First Line Imaging for CLTI with Dr. Mary Constantino on the BackTable VI Podcast)
New Tools for TIPS with Dr. George Behrens on the BackTable VI Podcast)
Improving Workflow Efficiency: Starting with Paracentesis with Dr. Karen Brown on the BackTable VI Podcast)
The Butterfly Story with Dr. John Martin on the BackTable VI Podcast)
Minimizing Complications for Lung Biopsies with Dr. Robert Suh on the BackTable VI Podcast)



Get in touch!

We want to hear from you. Let us know if you’re interested in partnering with BackTable as a Podcast guest, a sponsor, or as a member of the BackTable Team.

Select which show(s) you would like to subscribe to:

Thanks! Message sent.

bottom of page