Lessons

    1. TIPS Workup and Procedure Intro

    1. Tell us about how your referral pattern for TIPS has evolved

    2. How do you work with hepatologists to workup TIPS patients?

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

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

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

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

    7. How does the cross sectional help you with TIPS planning?

    8. Are there any times when you consider alternatives to TIPS?

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

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

    11. CME/CE Reflection: Module I

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

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

    3. Can you talk about the different TIPS sets?

    4. Talk about the needle pass and finding the right access site

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

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

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

    8. Can you discuss the gradients and what your goals are?

    9. Can you talk about embolization after deployment of the TIPS?

    10. What is your follow up and post procedural care protocol?

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

    12. CME/CE Reflection: Module II

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

    2. Tell us how you are using ICE for TIPS

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

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

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

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

    7. Are there other situations where the ICE catheter is useful?

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

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

    10. What wires and sheaths are you using for splenic access?

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

    12. CME/CE Reflection: Module III
  • 36 lessons
  • 2 hours of content
  • Earn up to 3 CME/CE credits