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

Be part of the conversation. Put your sponsored messaging on this episode. Learn how.

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 https://www.backtable.com

Free CME

Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs. Follow the button below to claim your credits on CMEfy.

BackTable CMEfy button

Stay Up To Date

Follow:

Subscribe:

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.

Resources

Disclaimer: The Materials available on BackTable.com 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.

backtable-earn-free-cme.jpg
Become a BackTable Sponsor

Up Next

Appropriate Use of IVUS in Lower Extremity Interventions: Expert Consensus with Dr. Eric Secemsky on the BackTable VI Podcast)
Tunneled Pleural and Peritoneal Catheters with Dr. Ally Baheti and Dr. Chris Beck on the BackTable VI Podcast)
How to Implement Advanced Vascular Ultrasound Techniques in Your Practice with Dr. Mary Costantino and Dr. Miguel Montero-Baker on the BackTable VI Podcast)
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)
Minimizing Complications for Lung Biopsies with Dr. Robert Suh on the BackTable VI Podcast)

Articles

Topics

Cirrhosis Condition Overview
Intravascular Ultrasound (IVUS) Procedure Prep
Liver Disease Condition Overview
Portal Hypertension Condition Overview
TIPS Procedure Steps & Technique

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